Methotrexate for Induction of Remission in Ulcerative Colitis

The review assessed the efficacy and safety of methotrexate for inducing remission in ulcerative colitis (UC) patients, including two studies with a total of 101 participants. One high-quality study (67 participants) compared oral methotrexate (12.5 mg/week) to placebo, showing no significant difference in remission rates. The other study (34 participants) compared methotrexate (15 mg/week) to 6-mercaptopurine and 5-aminosalicylic acid, also showing no significant differences. Adverse effects included leucopenia, migraine, rash, nausea, dyspepsia, and mild alopecia. The evidence quality was low to very low, and the results did not support the use of low-dose oral methotrexate for UC remission. Further research with higher doses or different administration routes was needed.