METHOTREXATE IN PEDIATRIC ULCERATIVE COLITIS: A RETROSPECTIVE SURVEY AT A SINGLE TERTIARY REFERRAL CENTER

Marina Aloi (1) , Giovanni Di Nardo (1) , Francesca Conte (1) , Luigi Mazzeo (2) , Nelson Cavallari (1) , Federica Nuti (1) , Salvatore Cucchiara (3) , Laura Stronati (4)

1 Pediatric Gastroenterology and Liver Unit
2 Pediatrics
3 Pediatric Gastroenterology
4 Section of Toxicology and Biomedical Sciences

BACKGROUND. Patients with ulcerative colitis (UC) often receive thiopurines as immunomodulators (IMs) to maintain remission and avoid corticosteroids (CS). If unresponsive or intolerant to these agents they are treated with methotrexate (MTX), an antimetabolite never assessed in pediatric UC. AIM. To describe the experience with MTX in UC children METHODS. Thirty-two patients (median age 13.9 years) received MTX. Pediatric Ulcerative Colitis Activity Index (PUCAI) and use of CS were the main outcomes evaluated baseline and at 3, 6 and 12 months. RESULTS. Indications to MTX were azathioprine (AZA) unresponsiveness in 18, AZA intolerance/toxicity in 10 and spondyloarthropathy in 4. Response or remission were achieved in 72%, 63% and 50% of patients at 3, 6 and 12 months, respectively. Mean PUCAI was 49.5±23.3 at baseline and 32.9±21.9, 29.5±21.8 and 29.4±19.9 at 3,6 and 12 months, respectively (p: 0.03). At the beginning of MTX 16 patients (50%) received CS, that were discontinued in 13 of them (81%) by 6 months. At the end of the study 11 patients (33%) needed short courses of CS for disease relapse. CONCLUSIONS. MTX may be useful in treating children with UC, although large, controlled trials are warranted to better define its effectiveness in pediatric UC.

Mots clés: Medicine

Marina Aloi, Giovanni Di Nardo, Francesca Conte, Luigi Mazzeo, Nelson Cavallari, et al.. METHOTREXATE IN PEDIATRIC ULCERATIVE COLITIS: A RETROSPECTIVE SURVEY AT A SINGLE TERTIARY REFERRAL CENTER. Alimentary Pharmacology and Therapeutics, 2010, 32 (8), pp.1017. ⟨10.1111/j.1365-2036.2010.04433.x⟩. ⟨hal-00566326⟩