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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2026; 32(2): 113432
Published online Jan 14, 2026. doi: 10.3748/wjg.v32.i2.113432
Published online Jan 14, 2026. doi: 10.3748/wjg.v32.i2.113432
Beyond rheumatology: Reconsidering methotrexate for Crohn’s disease in the biologic era
Jun-Young Seo, Jun Hwan Yoo, Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, South Korea
Author contributions: Seo JY and Yoo JH were involved in drafting the manuscript and critically revising it for important intellectual content. Both authors have approved the final version of the manuscript for publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Hwan Yoo, MD, PhD, Associate Professor, Division of Gastroen
Received: August 26, 2025
Revised: October 9, 2025
Accepted: November 24, 2025
Published online: January 14, 2026
Processing time: 140 Days and 2 Hours
Revised: October 9, 2025
Accepted: November 24, 2025
Published online: January 14, 2026
Processing time: 140 Days and 2 Hours
Core Tip
Core Tip: Methotrexate remains underutilized in Crohn’s disease management despite its favorable safety and established efficacy. The nationwide French survey by Bonnaud et al has shown that barriers are less about evidence than about clinical inertia and limited familiarity. Reconsidering methotrexate as a frontline immunomodulator, particularly in the biologic era, may provide a cost-effective and individualized therapeutic strategy.