Methotrexate in chronic active ulcerative colitis: a double-blind, randomized, Israeli multicenter trial.
OBJECTIVE
Uncontrolled studies have suggested that methotrexate may be effective in patients with active ulcerative colitis. The aim of this study was to evaluate the effectiveness of oral methotrexate in chronic steroid-dependent ulcerative colitis in a randomized, double-blind multicenter trial.


METHODS
Patients with active ulcerative colitis who have received steroids and/or immunosuppressives for at least 4 months during the preceding 12 months with a current Mayo Clinic score of > or = 7 were included in the study. Methotrexate (12.5 mg) or placebo was added to their treatment once weekly for 9 months.


RESULTS
Sixty-seven patients were included (methotrexate, 30 patients, placebo, 37 patients). The proportion of patients entering first remission (methotrexate, 46.7%; placebo, 48.6%), the time to reach first remission (methotrexate, 4.1 +/- 1.9 months; placebo, 3.4 +/- 1.7 months), as well as the proportions of patients having a relapse after first remission (methotrexate, 64.3%; placebo, 44.4%) were not significantly different between the two groups. The mean Mayo Clinic score, the mean monthly steroid dose, and the proportion of abnormal laboratory results during the study were also similar.


CONCLUSIONS
Methotrexate at a weekly oral dose of 12.5 mg was not found to be better than placebo in the induction or maintenance of remission in patients with chronic active ulcerative colitis.
Oren
R
R
Department of Gastroenterology, Ichilov Medical Center, Tel Aviv, Israel.
Arber
N
N
Odes
S
S
Moshkowitz
M
M
Keter
D
D
Pomeranz
I
I
Ron
Y
Y
Reisfeld
I
I
Broide
E
E
Lavy
A
A
Fich
A
A
Eliakim
R
R
Patz
J
J
Bardan
E
E
Villa
Y
Y
Gilat
T
T
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007557:Israel; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012074:Remission Induction
D007166:Immunosuppressive Agents; D008727:Methotrexate