Methotrexate therapy for primary biliary cirrhosis

Bach, Nancy; Bodian, Carol; Bodenheimer, Henry; Croen, Edward; Berk, Paul D.; Thung, Swan N.; Lindor, Keith D.; Therneau, Thierry; Schaffner, Fenton
January 2003
American Journal of Gastroenterology;Jan2003, Vol. 98 Issue 1, p187
Academic Journal
: ObjectivePreliminary data suggested possible benefits of methotrexate in primary biliary cirrhosis. We assessed the effectiveness of methotrexate use in primary biliary cirrhosis and its tolerance in patients with this disease.: MethodsA total of 110 primary biliary cirrhosis patients began methotrexate 15 mg/wk; for most, ursodeoxycholic acid was added during the study. We analyzed data from patients completing 5 yr of treatment with methotrexate to assess its effect on biochemical and histologic parameters after 5 yr of therapy. Based on an intent to treat analysis, we also compared survival of our patients (n = 110) with that of patients in a previously published, placebo-controlled trial of ursodeoxycholic acid (n = 180).: ResultsOnly half of the study group completed 5 yr of methotrexate therapy. Therapy did not prevent progression of disease, as indicated by a rising Mayo risk score. Portal fibrosis tended to remain the same. Methotrexate did not diminish the risk of death or liver transplantation when compared with ursodeoxycholic acid or placebo; however, ursodeoxycholic acid use decreased the risk of death or transplant (p = 0.006).: ConclusionsMethotrexate is not well tolerated in primary biliary cirrhosis. The toxicity of methotrexate and its inability to prevent complications of progressive liver disease or improve survival and the need for liver transplantation limits its utility. The benefits of ursodeoxycholic acid were again confirmed.


Related Articles

  • 6-Mercaptopurine hepatotoxity during acute lymphocytic leukemia maintenance therapy. Skirvin, J. Andrew; Valley, Amy W.; Relias, Valerie; Morris, Ashley K. // Journal of Oncology Pharmacy Practice;Jun1998, Vol. 4 Issue 2, p117 

    Investigates the case of 6-mercaptopurine acute fulminate hepatotoxicity. Risk of patients with 6MP hepatotoxicity; Factors causing the hepatotoxicity of 6MP and methotrexate; Significance of 6MP in the occurrence of liver damage.

  • New ankylosing spondylitis option. Dunkin, Mary Anne // Arthritis Today;May/Jun96, Vol. 10 Issue 3, p8 

    Suggests that methotrexate may be an effective treatment for ankylosing spondylitis (AS). What is AS; Consequences of not treating the disease; Traditional methods of treatment; What study reveals about this treatment alternative for this disease; Side affects from the drug.

  • Methotrexate.  // Reactions Weekly;7/10/2010, Issue 1309, p28 

    The article describes the case of a 44-year old woman who acquired pneumonitis while undergoing treatment with oral methotrexate.

  • Immunosuppressants.  // Reactions Weekly;8/14/2010, Issue 1314, p23 

    The article describes the case of a 14-year-old boy who acquired acute tuberculous pleuropneumonia while undergoing treatment with mercaptopurine and methotrexate.

  • Methotrexate.  // Reactions Weekly;2/23/2013, Issue 1440, p25 

    The article presents a case study of a 15-year-old boy who developed anaphylaxis while receiving a high-dose methotrexate (HDMTX); he was later desensitized to methotrexate.

  • Literature reviews. Lampe, John B.; Jacobs, Jerry C. // Clinical Pediatrics;May1997, Vol. 36 Issue 5, p305 

    Presents a summary of the paper `Liver Biopsy Findings in Patients with Juvenile Rheumatoid Arthritis Receiving Long-Term, Weekly Methotrexate Therapy,' by Kugathasan S., Newman A., et al. Indications of liver biopsy; Efficacy of a weekly dosage of methotrexate for juvenile rheumatoid arthritis...

  • Methotrexate for Maintaining Remission of Crohn's Disease. Kirchner, Jeffrey T. // American Family Physician;12/1/2000, Vol. 62 Issue 11, p2506 

    Presents an abstract of the study `A Comparison of Methotrexate With Placebo for the Maintenance of Remission in Crohn's Disease,' by B.G. Feagan et al., from the June 1, 2000 issue of the `New England Journal of Medicine.'

  • Methotrexate treatment of squamous-cell head and neck cancers: dose-response evaluation. Woods, R.L.; Fox, R.M.; Tattersall, M.H.N. // British Medical Journal (Clinical Research Edition);2/21/1981, Vol. 282 Issue 6264, p600 

    Evaluates the response of patients with squamous-cell head and neck carcinoma to methotrexate. Evidence of toxicity in high-dose regimen; Improvement of the response rate; Duration of survival of patients with high-dose regimen.

  • Methotrexate toxicity induced by acute renal failure. Soon, Christine; Ilchyshyn, A // Journal of the Royal Society of Medicine;Feb2005, Vol. 98 Issue 2, p83 

    A letter to the editor is presented in response to the article "Methotrexate Toxicity Induced by Renal Failure," by A. Strang and T. Pullar in the November 2004 issue.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics