A Case of Crohn's Disease Showing Favorable Response to Induction and Maintenance Therapy with Methotrexate after Failure of Anti-tumor Necrosis Factor Therapy.
10.4166/kjg.2015.66.4.231
- Author:
Jungran CHOI
1
;
Gak Won YUN
;
Yoo Mi PARK
;
Jie Hyun KIM
;
Young Hoon YOUN
;
Hyojin PARK
;
Jae Jun PARK
Author Information
1. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jaejpark@yush.ac
- Publication Type:Case Reports ; English Abstract
- Keywords:
Methotrexate;
Maintenance;
Crohn disease;
Remission induction
- MeSH:
Adult;
Antibodies, Monoclonal/therapeutic use;
Colonoscopy;
Crohn Disease/diagnosis/*drug therapy;
Humans;
Immunosuppressive Agents/*therapeutic use;
Infliximab/therapeutic use;
Male;
Methotrexate/*therapeutic use;
Remission Induction;
Tomography, X-Ray Computed;
Tumor Necrosis Factor-alpha/immunology
- From:The Korean Journal of Gastroenterology
2015;66(4):231-236
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Thanks to the introduction of immumomodulators and biologics, therapeutic approaches in Crohn's disease have changed significantly during the past decade. Although new biologic therapy has dramatically improved the treatment of Crohn's disease, a substantial number of patients are refractory to these therapies or lose their initial response. Methotrexate (MTX) is a structural analogue of folic acid that can competitively inhibit the binding of dihydrofolic acid to the enzyme dihydrofolate reductase and has been widely used as immunomodulator in rheumatology area for patients with rheumatoid arthritis and psoriasis. Although MTX has also been shown to be an effective agent for remission induction and maintenance of remission in Crohn's disease, the use of MTX in Crohn's disease has not yet been reported in Korea. Herein, we report a case of Crohn's disease patient who was successfully treated with MTX after treatment failure with thiopurine and anti-tumor necrosis factor.
