Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 15: Methotrexate in the Treatment of Crohn’s Disease (continued)

Ellen J. Scherl, Md, FACP, AGAF; Arun Swaminath, MD; Ryan Urquhart Warren, MD; Harrison Lakehomer, BA

Although steroids have been a mainstay of therapy for moderate-to-severe Crohn’s disease, recently, there has been a tectonic shift toward earlier use of biologic or immunomodulator therapy aimed at steroid-free remission.10-13 It has been long recognized that while steroids are effective in inducing remission, they are ineffective in maintaining remission in Crohn’s disease14,15 with approximately two thirds of patients being either steroid dependent or refractory.16,17 Furthermore, cost benefit analyses confirm that…