Cochrane Summaries

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Methotrexate for treatment of inactive Crohn's disease

Patel V, MacDonald JK, McDonald JW, Chande N
Published Online: 
7 October 2009

Crohn's disease is a chronic inflammatory disease of the intestines that frequently occurs in the lower part of the small intestine, called the ileum. However, Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus. The most common symptoms are abdominal pain and diarrhea. Methotrexate is a drug that suppresses the body's natural immune responses and may suppress inflammation associated with Crohn’s disease. This review shows that methotrexate (15 mg/week) injected intramuscularly (i.e. into muscles located in the arm or thigh) for 40 weeks is an effective treatment for preventing relapse (return of disease symptoms) among patients whose disease became inactive while taking higher doses of intramuscular methotrexate (25 mg/week). Side effects occurred in a small number of patients. These side effects are usually mild in nature and include nausea and vomiting, cold symptoms, abdominal pain, headache, joint pain and fatigue. Methotrexate (12.5 to 15 mg/week) taken orally has not been shown to be effective treatment for inactive Crohn's disease. However, there has been little study of this approach.