Methotrexate is the re-discovered drug for Crohn’s disease

Methotrexate, the analog of folic acid, was introduced for clinical practice more than 60 years ago being utilized for immune- -mediated disorders including also Crohn’s disease. In the diff erence from rheumatoid arthritis patients, methotrexate in Crohn’s disease patients is used in higher dosages and preferable route of administration is parenteral (subcutaneous) application. Indication for methotrexate therapy is a mild to moderate severity of Crohn’s disease after induction the remission due to topic or systemic corticosteroids therapy. Other indication for methotrexate therapy is concomitant immunosuppressive therapy with anti-TNF drugs. The cotemporary application of methotrexate is associated with higher trough level of infl iximab and in less frequent of anti-drugs antibody production. Comparing to thiopurins, methotrexate therapy is associated with lower risk of severe side eff ects and there is no contraindication to start therapy in those patients with a history of malignancy.