Interesting Article on Methotrexate and Pediatric Crohns

[crohnsinct]

Of particular interest is the reference to using it with Remicade to slow Remicade clearance. I had never heard that.

Also, it s fast acting? 4-6 weeks...hmmm our GI quotes 12 weeks.

http://www.pediatricnews.com/news/c...dvocated-for-crohn-s-patients/dc274b52da.html

 

[Farmwife]

I like this quote from the study

Thiopurine use also is associated with a fourfold increase in lymphoma in Crohn's disease, Dr. Baldassano said. But methotrexate has never been epidemiologically associated with cancer. “I spent a lot of time looking at the literature for this talk, and it appears that methotrexate may be less toxic than 6-mercaptopurine and azathioprine,” he said.

I still wish we could do mtx only but it's just not enough.

 

[pdx]

Interesting. Big MTX fans here. We felt like MTX helped our daughter within days of starting it; maybe that was due to it helping to keep Remicade levels higher. And that matches up with the results of E's levels testing. Before MTX, she had no detectable Remicade after 4 weeks, but 2 infusions after starting MTX, she had a detectable level after 6 weeks. (Though that could also be due to her decreasing inflammation.)

 

[my little penguin]

http://www.everydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-and-your-lymphoma-risk.aspx

So still a risk for Mtx .
The important key here is untamed inflammation of the gut or joints
Increases cancer risk regardless of meds .

ANti tnf so far hadn't been linked to lymphoma in long term studies as monotherapy - it's the immunosuppressants including Mtx

 

[my little penguin]

https://www.jrheum.com/subscribers/01/12/2573.html

 

[my little penguin]

Abstract

Patients with rheumatoid arthritis (RA) are known to develop lymphoproliferative disorders (LPDs) during the course of illness, particularly in cases treated with methotrexate (MTX) for long periods. We describe a case of MTX-related Epstein-Barr-virus-(EBV-) associated LPD resembling Hodgkin’s lymphoma (HL), in which a dramatic complete remission was achieved after withdrawal of MTX coupled with clarithromycin (CAM) administration. Withdrawal of MTX coupled with CAM administration seemed to be effective for treating MTX-related EBV-associated LPDs. In particular, an immunomodulative effect of CAM might have been involved in achieving complete remission.

From
http://www.hindawi.com/journals/crihem/2012/658745/