Oral, rather than subcutaneous, methotrexate avoids weekly injections, reduces costs and might improve quality of life in children with Crohn's disease. 226 children with Crohn's disease were included in a study to assess methods of administration of this drug. The subcutaneous route was found to be superior to oral administration; however, the authors highlight that these findings were only true for some outcomes, and with a modest effect size. In some children in complete remission, it might be reasonable to consider switching from subcutaneous to oral methotrexate, although close monitoring is needed.
References
Turner, D. et al. Efficacy of oral methotrexate in paediatric Crohn's disease: a multicentre propensity score study. Gut 10.1136/gutjnl-2014-307964
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Is oral or subcutaneous methotrexate superior for paediatric Crohn's disease?. Nat Rev Gastroenterol Hepatol 12, 5 (2015). https://doi.org/10.1038/nrgastro.2014.224
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DOI: https://doi.org/10.1038/nrgastro.2014.224