Cochrane · systematic review · CD003459
Methotrexate for induction of remission in refractory Crohn's disease
McDonald, JWD, Wang, Y, Tsoulis, DJ, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
20
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 11 · 55%Low 8 · 40%Moderate 1 · 5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Methotrexate compared to placebo for induction of remission in refractory Crohn's disease
Population: Adult patients with refractory Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to enter remission or possible remission at 16 weeks (Arora 1999) Methotrexate vs placebo | RR 3 [0.68, 13.31] | 1 study · 33 participants | Low Downgraded: risk of bias, imprecision |
Failure to enter remission or possible remission at 16 weeks (Oren 1997) Methotrexate vs placebo | RR 1.05 [0.79, 1.39] | 1 study · 52 participants | Low Downgraded: risk of bias, imprecision |
Failure to enter remission or possible remission at 16 weeks (Feagan 1995) Methotrexate vs placebo | RR 0.75 [0.61, 0.93] | 1 study · 141 participants | Moderate Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Feagan 1995) Methotrexate vs placebo | RR 8 [1.09, 58.51] | 1 study · 141 participants | Low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Oren 1997) Methotrexate vs placebo | RR 3 [0.13, 70.42] | 1 study · 52 participants | Low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Arora 1999) Methotrexate vs placebo | RR 8.31 [0.46, 149.21] | 1 study · 33 participants | Low Downgraded: risk of bias, imprecision |
Methotrexate compared to 6‐MP or azathioprine for induction of remission in refractory Crohn's disease
Population: adult patients with refractory Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to enter remission or possible remission at 24‐36 weeks (Oren 1997) Methotrexate vs 6‐MP or azathioprine | RR 1.36 [0.97, 1.92] | 1 study · 58 participants | Low Downgraded: risk of bias, imprecision |
Failure to enter remission or possible remission at 24‐36 weeks (Maté‐Jiménez 2000) Methotrexate vs 6‐MP or azathioprine | RR 3.2 [0.37, 27.49] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Failure to enter remission or possible remission at 24‐36 weeks (Ardizzone 2003) Methotrexate vs 6‐MP or azathioprine | RR 1.2 [0.63, 2.29] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (Ardizzone 2003) Methotrexate vs 6‐MP or azathioprine | RR 2.43 [1.21, 4.89] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Oren 1997) Methotrexate vs 6‐MP or azathioprine | RR 1.23 [0.08, 18.74] | 1 study · 58 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Maté‐Jiménez 2000) Methotrexate vs 6‐MP or azathioprine | RR 2.13 [0.22, 21.17] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Ardizzone 2003) Methotrexate vs 6‐MP or azathioprine | RR 1 [0.22, 4.52] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Methotrexate compared to 5‐ASA for induction of remission in refractory Crohn's disease
Population: Adult patients with refractory Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to enter remission or possible remission at 30 weeks (Maté‐Jiménez 2000) Methotrexate vs 5‐ASA | RR 0.23 [0.08, 0.67] | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawal due to adverse event (Maté‐Jiménez 2000) Methotrexate vs 5‐ASA | RR 2.5 [0.14, 46.14] | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Methotrexate + infliximab compared to infliximab alone for induction of remission in refractory Crohn's disease
Population: adult patients with refractory Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to enter remission at 14 weeks or 24 weeks (Feagan 2014) Methotrexate + infliximab vs infliximab alone | RR 1.07 [0.57, 2.03] | 1 study · 126 participants | Low Downgraded: risk of bias, imprecision |
Failure to enter remission at 14 weeks or 24 weeks (Schröder 2006) Methotrexate + infliximab vs infliximab alone | RR 0.73 [0.31, 1.69] | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (Schröder 2006) Methotrexate + infliximab vs infliximab alone | RR 1.02 [0.51, 2.05] | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (Schröder 2006) Methotrexate + infliximab vs infliximab alone | RR 0.25 [0.01, 5.45] | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse event (Feagan 2014) Methotrexate + infliximab vs infliximab alone | RR 2 [0.19, 21.5] | 1 study · 126 participants | Low Downgraded: risk of bias, imprecision |