Therapeutic role of methotrexate in pediatric Crohn’s disease


  • Zlatko Djurić Division of Gastroenterology, Children’s Hospital, Faculty of Medicine, University of Niš, Niš, Serbia
  • Ljiljana Šaranac Division of Endocrinology, Children’s Hospital, Faculty of Medicine, University of Niš, Niš, Serbia
  • Ivana Budić Clinic for Pediatric Surgery and Orthopedics, Faculty of Medicine, University of Niš, Niš, Serbia
  • Voja Pavlović Institute of Physiology, Faculty of Medicine, University of Niš, Niš, Serbia
  • Jelena Djordjević Faculty of Medicine, University of Niš, Niš, Serbia



Methotrexate, Crohn’s disease, children, therapy, MTX, thiopurines, immunomodulator, remission


The main role of therapy in Crohn’s disease (CD) is to achieve long-term clinical remission, and to allow for normal growth and development of children. The immunomodulatory drugs used for the maintenance of remission in CD include thiopurines (azathioprine and 6-mercaptopurine) and methotrexate (MTX). Development of hepatosplenic T-cell lymphoma in some patients with inflammatory bowel disease, treated with thiopurines only or in combination with anti-tumor necrosis factor agents, resulted in a growing interest in the therapeutic application of MTX in children suffering from CD. This review summarizes the literature on the therapeutic role of MTX in children with CD. MTX is often administered as a second-line immunomodulator, and 1-year clinical remission was reported in 25–69% of children with CD after excluding for the use of thiopurines. Initial data on MTX effectiveness in mucosal healing, and as a first-line immunomodulator in pediatric patients with CD, are promising. A definite conclusion, however, may only be made on the basis of additional research with a larger number of subjects.



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Author Biographies

  • Zlatko Djurić, Division of Gastroenterology, Children’s Hospital, Faculty of Medicine, University of Niš, Niš, Serbia
    Division of Gastroenterology
  • Ljiljana Šaranac, Division of Endocrinology, Children’s Hospital, Faculty of Medicine, University of Niš, Niš, Serbia
    Division of Endocrinology


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Therapeutic role of methotrexate in pediatric Crohn’s disease


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Therapeutic role of methotrexate in pediatric Crohn’s disease. Biomol Biomed [Internet]. 2018 Aug. 1 [cited 2024 Jul. 19];18(3):211-6. Available from: