Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

14 questions · 25 findings · 2 reviews · Headline outcomes only

No studies found 0 · 0%GRADE not reported 0 · 0%Very low 12 · 48%Low 10 · 40%Moderate 3 · 12%High 0 · 0%

Methotrexate vs placebo

Failure to enter remission or possible remission at 16 weeks (Arora 1999) · adult patients with refractory Crohn's disease

Methotrexate showed no clear difference in failure to enter remission or possible remission at 16 weeks (Arora… compared with placebo (low certainty).

3 findings from 1 review

Methotrexate vs 6‐MP or azathioprine

Withdrawals due to adverse events · adult patients with refractory Crohn's disease

It is very uncertain whether methotrexate changes withdrawal due to adverse event (Oren 1997) compared with 6‐MP or azathioprine (very low certainty).

3 findings from 1 review

Methotrexate vs 5‐aminosalicylic acid (5‐ASA) (mesalazine)

Failure to enter remission or possible remission at 16 weeks (Arora 1999) · adult patients with refractory Crohn's disease

It is very uncertain whether methotrexate changes failure to enter remission or possible remission at 30 weeks… compared with 5‐ASA (very low certainty).

1 finding from 1 review

Methotrexate vs placebo

Withdrawals due to adverse events · adult patients with refractory Crohn's disease

Methotrexate may leads to higher withdrawal due to adverse event (Feagan 1995) compared with placebo (low certainty).

3 findings from 1 review

Methotrexate vs 6‐MP or azathioprine

Failure to enter remission or possible remission at 16 weeks (Arora 1999) · adult patients with refractory Crohn's disease

Methotrexate showed no clear difference in failure to enter remission or possible remission at 24‐36 weeks… compared with 6‐MP or azathioprine (low certainty).

3 findings from 1 review

Methotrexate vs placebo

Maintenance of clinical remission · Participants with Crohn's disease in remission

Methotrexate probably leads to higher proportion of patients maintaining clinical remission compared with placebo (moderate certainty).

3 findings from 1 review

Methotrexate + infliximab vs infliximab

Failure to enter remission at 14 weeks or 24 weeks (Feagan 2014) · adult patients with refractory Crohn's disease

Methotrexate + infliximab showed no clear difference in failure to enter remission at 14 weeks or 24 weeks (Feagan 2014) compared with infliximab alone (low certainty).

2 findings from 1 review