How Effective Is Methotrexate for Crohn's?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 30 July 2019
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Studies on methotrexate for Crohn’s disease show the medication can effectively induce and maintain remission in some patients. This condition is autoimmune in nature and involves chronic painful inflammation of the bowel. Over time it can lead to severe lesions that may necessitate surgical treatment, and can expose the patient to an increased risk of cancer. Several medications are available to treat Crohn’s disease, and methotrexate may be considered among these options for patients who might benefit from it.

A landmark study published in the New England Journal of Medicine in 2000 showed that patients treated with methotrexate performed approximately twice as well as those on a placebo. This indicates that methotrexate for Crohn’s can be effective, as it worked in around two thirds of the patients in the study. It can address ongoing flareups to suppress the disease, and is also suitable for maintenance therapy to keep the condition at bay. Side effects in this and other studies on the use of methotrexate for Crohn's were moderate and appeared to outweigh the benefits.


Steroid medications can work extremely well for short term control of Crohn’s disease, but they are not usually appropriate for long term use due to increased risks for the patient. As a result, care providers are eager to locate good options for maintenance therapy. Studies showing that methotrexate for Crohn’s can be effective were important, as they provided another choice of medication. Patients who do not respond to other drugs or would be poor candidates for them might be able to use methotrexate to manage the condition.

This drug acts by inhibiting the metabolism of folic acid in the body. Growing and dividing cells need folic acid to function. By suppressing the concentration of this substance in the body, methotrexate can inhibit uncontrolled cell growth. This is a common problem with inflammation, where irritated tissue keeps producing new cells. In addition to causing discomfort, this can also increase the chances of a rogue cell division that might cause cancer.

Patients considering methotrexate for Crohn’s can discuss the risks and benefits in their case with a physician. It is important to get off medications like steroids, which are not safe for long term use. The doctor may provide information about several options the patient can try to find a medication that is effective and safe. Methotrexate can potentially have severe side effects, including immune suppression and organ damage. It is important to follow precautions while on the drug and to report side effects to a care provider if they develop.



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