{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:41:31Z","timestamp":1780929691325,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T00:00:00Z","timestamp":1615680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Methotrexate can be used to maintain remission in Crohn's disease patients who are intolerant to thiopurines. Data on its use as monotherapy in other scenarios are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the effectiveness of methotrexate monotherapy in Crohn's disease patients after previous failure to anti\u2010tumour necrosis factor (anti\u2010TNF\u03b1) drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, observational multicentre study of data from the Spanish ENEIDA registry. Participants were patients with active Crohn's disease and previous failure to anti\u2010TNF\u03b1 started on methotrexate monotherapy. Short\u2010term effectiveness was assessed at 12\u201016\u00a0weeks based on Harvey\u2010Bradshaw index (HBI): clinical remission as HBI\u00a0\u2264\u00a03 points and clinical response as HBI drop of\u00a0\u2265\u00a03 points over baseline. Long\u2010term effectiveness was defined as steroid\u2010free methotrexate persistence from 12 to 16\u00a0weeks until maximum follow up. Adverse events were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were compiled for 110 patients treated with methotrexate after a failed response to one (39%) or two (55.6%) anti\u2010TNF\u03b1 agents. Short\u2010term clinical response and remission rates were 60% and 30.9% respectively. Of 74 patients who continued after week 16, long\u2010term effectiveness was achieved in 82% and 74% at 12 and 24\u00a0months respectively. In the multivariate analysis, non\u2010remission at short term (vs remission) was associated with long\u2010term failure (HR 2.58, 95%CI 1.95\u20103.68, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.028). Adverse events (evaluated in 100 patients) were recorded in 44%, and in 30.4% of these patients, they led to methotrexate discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The benefits observed suggest methotrexate monotherapy could be a valid option in Crohn's disease patients with previous failure to anti\u2010TNF\u03b1.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16315","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T14:40:21Z","timestamp":1693579221000},"page":"1021-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effectiveness and safety of methotrexate monotherapy in patients with Crohn\u2019s disease refractory to anti\u2010TNF\u2010\u03b1: results from the ENEIDA 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