Safety of methotrexate for inflammatory bowel disease.

Saibeni et al. [ [1] Saibeni S. Bollani S. Losco A. et al. The use of methotrexate for treatment of inflammatory bowel disease in clinical practice. Dig Liver Dis. 2012; 44 ([Epub 2011 November 2]): 123-127 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar ] demonstrate the effectiveness of methotrexate (MTX) in IBD patients; nevertheless, its tolerability raises critical concerns, as side effects developed in 49 patients (43.7%), and MTX was discontinued in 38 (33.9%). MTX-induced hepatotoxicity can occur with long-term use, occasionally presenting as acute transaminase flares; we observed a patient with this symptom in whom serological and histological characteristics of autoimmune hepatitis (AIH) appeared, which resolved with corticosteroids [ [2] Moreno-Otero R. Garcia-Buey L. García-Sánchez A. et al. Autoimmune hepatitis alter long-term methotrexate therapy for rheumatoid arthritis. Curr Drug Safety. 2011; 6: 197-200 Crossref PubMed Scopus (13) Google Scholar ].