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Tumor Necrosis Factor 길항제 치료 실패 후 Methotrexate로 관해 유도와 유지 치료가 가능했던 크론병
최정란 ( Jungran Choi ),윤각원 ( Gak Won Yun ),박유미 ( Yoo Mi Park ),김지현 ( Jie Hyun Kim ),윤영훈 ( Young Hoon Youn ),박효진 ( Hyojin Park ),박재준 ( Jae Jun Park ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.4
Thanks to the introduction of immumomodulators and biologics, therapeutic approaches in Crohn’s disease have changed significantly during the past decade. Although new biologic therapy has dramatically improved the treatment of Crohn’s disease, a substantial number of patients are refractory to these therapies or lose their initial response. Methotrexate (MTX) is a structural analogue of folic acid that can competitively inhibit the binding of dihydrofolic acid to the enzyme dihydrofolate reductase and has been widely used as immunomodulator in rheumatology area for patients with rheumatoid arthritis and psoriasis. Although MTX has also been shown to be an effective agent for remission induction and maintenance of remission in Crohn’s disease, the use of MTX in Crohn’s disease has not yet been reported in Korea. Herein, we report a case of Crohn’s disease patient who was successfully treated with MTX after treatment failure with thiopurine and anti-tumor necrosis factor. (Korean J Gastroenterol 2015,66:231-236)