Evidence map›Paper›PMID 30888405›Full record

ArticleJournal of Crohn's & colitis2019

Low-dose Methotrexate has Similar Outcomes to High-dose Methotrexate in Combination with Anti-TNF Therapy in Inflammatory Bowel Diseases.

Nienke Z Borren, Jay Luther, Francis P Colizzo, John G Garber, Hamed Khalili, Ashwin N Ananthakrishnan

Open access · greenAbstract read
In one paragraph

Article in Journal of Crohn's & colitis, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. The roles and heterogeneity of CD8International journal of molecular medicine · 2026
    Review
  3. Observational
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Nienke Z BorrenDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Jay LutherDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Francis P ColizzoDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
John G GarberDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Hamed KhaliliDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Ashwin N AnanthakrishnanDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Massachusetts General Hospital · USHarvard University · US

Funding

Pilot & Feasibility ProgramP30DK043351 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI RAYMOND T CHUNG · 1991 to 2026
$35.3M
Genetic predictors of calprotectin response with anti-TNF and anti-integrin therapy in inflammatory bowel diseasesR03DK112909 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI ANANTHAKRISHNAN, ASHWIN N · 2017 to 2018
$171k
NIDDK NIH HHS P30 DK043351NIDDK NIH HHS R03 DK112909
6 · The paper itself

Abstract

BACKGROUND AND

aimsMethotrexate [MTX] is a well-known immunomodulator in the treatment of inflammatory bowel disease [IBD] and is often combined with biologic agents. The ideal MTX dose for combination therapy has not been determined. This study aimed to investigate the effect of varying doses of MTX on efficacy and safety outcomes when used with anti-TNF agents in IBD.

methodsThis study included patients with Crohn's disease [CD] or ulcerative colitis [UC] receiving care between January 2005 and June 2018. Low-dose MTX was defined as ≤12.5 mg/week and high-dose as >12.5 mg/week. The primary efficacy outcome was a composite of need for IBD-related hospitalization or surgery, steroid initiation, or change of biologic agent within 1 year. Safety outcomes included side effects related to MTX, serious infections, malignancy, and need to discontinue MTX therapy within 1 year. Multivariable logistic regression models adjusting for relevant covariates were used to assess independent association between MTX dose and outcomes.

resultsOur study included 222 patients with IBD [163 CD, 59 UC]. Just under a third were receiving low-dose MTX [28%]. The primary efficacy composite outcome was noted in 75 patients [47%] in the high-dose MTX group compared with 23 patients [37%] in the low-dose MTX group [p = 0.15]. We found no significant associations between MTX dose and any side effect [odds ratio 1.59, 95% confidence interval 0.77-3.31, p = 0.21] or development of serious infections [odds ratio 1.19, 95% confidence interval 0.41-3.45, p = 0.76].

conclusionsLow-dose and high-dose MTX combination therapy were equally effective, and no difference in infection or malignancy rates was observed.

Indexed as

Inflammatory Bowel DiseasesMethotrexateTumor Necrosis Factor InhibitorsAdultDose-Response Relationship, DrugDrug MonitoringDrug Therapy, CombinationFemaleHumansImmunologic FactorsMaleMiddle AgedRemission InductionRetrospective StudiesTreatment OutcomeUnited StatesImmunologic FactorsMethotrexateTumor Necrosis Factor Inhibitorsanti-TNF therapyinflammatory bowel diseaseMethotrexate

Identifiers

PMID30888405
PMCPMC6692531
OpenAlexW2923972615

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.