Therapeutic role of methotrexate in pediatric Crohn’s disease

Zlatko Djurić; Ljiljana Šaranac; Ivana Budić; Voja Pavlović; Jelena Djordjević

doi:10.17305/bjbms.2018.2792

Authors

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 https://orcid.org/0000-0001-5364-924X
Voja Pavlović Institute of Physiology, Faculty of Medicine, University of Niš, Niš, Serbia
Jelena Djordjević Faculty of Medicine, University of Niš, Niš, Serbia

DOI:

https://doi.org/10.17305/bjbms.2018.2792

Keywords:

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

Abstract

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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