Efficacy and tolerance of methotrexate in maintenance of remission in 49 patients with Crohn′s disease
10.3760/cma.j.issn.0254-1432.2016.07.011
- VernacularTitle:甲氨蝶呤在49例克罗恩病患者维持缓解治疗中的疗效和耐受性分析
- Author:
Tianyu ZHANG
;
Jie ZHONG
;
Zhengting WANG
;
Shurong HU
;
Mengmeng CHENG
;
Maochen ZHANG
;
Yun LIN
;
Jie ZHOU
;
Lei WANG
;
Rong FAN
- Publication Type:Journal Article
- Keywords:
Methotrexate;
Crohn disease;
Maintenance of remission;
Efficacy;
Tolerability
- From:
Chinese Journal of Digestion
2016;36(7):466-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the efficacy and tolerance of methotrexate(MTX)in remission maintenance of Crohn′s disease (CD).Methods From June 2012 to August 2015 ,49 CD patients who received MTX as mainly treatment medication to maintain remission were enrolled.The pre-medication history,efficacy,dosage and side effects of MTX were analyzed.The effects of inducing strategy on disease recurrence were analyzed.Chi-square test and t test were used for statistical analysis.Results Among the 49 patients,34 (69.4%)received steroids for remission inducing,nine (18.4%)received infliximab for remission inducing and six (12.2%)achieved remission after operation.In the 44 patients treated with azathioprine (AZA)before,the median treatment time was one month and the dosage for withdrawal of AZA was (42.0 ± 14.8)mg/d.The most common reason was leucopenia (81 .8%, 36/44).Till the time point of follow-up,46 of the 49 CD patients still took MTX orally with a median treatment time of 16 months,and the weekly dosage was (12.7 ±2.0)mg.Thirty-one cases (67.4%) achieved clinical stability,while 15 cases (32.6%)underwent clinical recurrence.The median Crohn′s disease activity index (CDAI)was 123.5 ± 66.6.The weekly dosage of clinical stability group was (12.5 ±2.1)mg,and that of clinical recurrence group was (13.0 ±1 .7 )mg,there was no statistically significant difference between the two groups (t =0.802,P =0.426 ).The recurrence rate of steroids-induced remission group was 41 .2% (14/34 ),which was higher than that of infliximab and surgery-induced remission group (1/15),and the differnce was statistically significant (χ2 =5 .177,P =0.023 ). The common side effects were gastrointestinal reaction (26.5 %, 13/49 ), impaired liver function (20.4%,10/49)and leukopenia (12.2%,6/49).Only three cases could not tolerate the side effects and underwent medication withdrawal.Conclusions As a second-line immunosuppressant for maintanence remission in CD,MTX is effective and well-tolerated in patients.So it can be an important option during the long course of CD.
