title: [Reccomendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on the use of methotrexate in inflammatory bowel disease].
abstract: Methotrexate is an immunosuppressant that may be useful in several clinical scenarios in inflammatory bowel disease. In this article, we review the available evidence in Crohn's disease and ulcerative colitis and establish general recommendations for its use in clinical practice. Although the available data are limited, it is very likely that methotrexate is underused because its effectiveness is underestimated and its toxicity is overestimated. Both in induction therapy and in maintenance of remission, methotrexate is useful in Crohn's disease. When prescribed in combination with biologic agents, immunogenicity is less frequent and consequently long-term response could potentially be improved. There are few published studies, but several data suggest that methotrexate could also be useful in ulcerative colitis. Although myelotoxicity and liver toxicity are well known risks, methotrexate is a drug that is well tolerated in many patients, even in the long term.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, IIS Aragón, España Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). Electronic address: fgomollon@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.affiliation: Servicio de Aparato Digestivo, Hospital de Navarra, PamplonaEspaña.
authors.forename: Saioa
authors.initials: S
authors.lastname: Rubio
authors.affiliation: Servicio de Aparato Digestivo, Hospital Royo Villanova, Zaragoza España.
authors.forename: Mara
authors.initials: M
authors.lastname: Charro
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Santiago
authors.initials: S
authors.lastname: García-López
authors.affiliation: Servicio de Aparato Digestivo, Hospital de León, León España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Muñoz
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: Servicio de Aparato Digestivo, Hospital Germans Trías i Pujol, Badalona España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
authors.forename: Eugeni
authors.initials: E
authors.lastname: Domènech
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000139:chemically induced; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D017294:Ondansetron / Q000627:therapeutic use
chemical_list: D000932:Antiemetics; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D017294:Ondansetron; D005492:Folic Acid; D008727:Methotrexate
keywords: Colitis ulcerosa; Crohn's disease; Enfermedad de Crohn; Immunosuppression; Inmunosupresión.; Methotrexate; Metotrexato; Ulcerative colitis