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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Methotrexate versus placebo, Outcome 1 Failure to enter remission or possible remission at 16 weeks.
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Analysis 1.1

Comparison 1 Methotrexate versus placebo, Outcome 1 Failure to enter remission or possible remission at 16 weeks.

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Comparison 1 Methotrexate versus placebo, Outcome 2 Withdrawal due to adverse event.
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Analysis 1.2

Comparison 1 Methotrexate versus placebo, Outcome 2 Withdrawal due to adverse event.

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Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 1 Failure to enter remission or possible remission at 24‐36 weeks.
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Analysis 2.1

Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 1 Failure to enter remission or possible remission at 24‐36 weeks.

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Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 2 Adverse events.
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Analysis 2.2

Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 2 Adverse events.

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Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 3 Withdrawal due to adverse event.
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Analysis 2.3

Comparison 2 Methotrexate versus 6‐MP or Azathioprine, Outcome 3 Withdrawal due to adverse event.

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Comparison 3 Methotrexate versus 5‐ASA, Outcome 1 Failure to enter remission or possible remission at 30 weeks.
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Analysis 3.1

Comparison 3 Methotrexate versus 5‐ASA, Outcome 1 Failure to enter remission or possible remission at 30 weeks.

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Comparison 3 Methotrexate versus 5‐ASA, Outcome 2 Withdrawal due to adverse event.
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Analysis 3.2

Comparison 3 Methotrexate versus 5‐ASA, Outcome 2 Withdrawal due to adverse event.

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Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 1 Failure to enter remission at 14 weeks or 24 weeks.
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Analysis 4.1

Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 1 Failure to enter remission at 14 weeks or 24 weeks.

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Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 2 Adverse events.
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Analysis 4.2

Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 2 Adverse events.

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Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 3 Serious adverse events.
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Analysis 4.3

Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 3 Serious adverse events.

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Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 4 Withdrawals due to adverse event.
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Analysis 4.4

Comparison 4 Methotrexate and Infliximab versus Infliximab, Outcome 4 Withdrawals due to adverse event.

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Comparison 1. Methotrexate versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure to enter remission or possible remission at 16 weeks Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Withdrawal due to adverse event Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Methotrexate versus placebo
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Comparison 2. Methotrexate versus 6‐MP or Azathioprine

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure to enter remission or possible remission at 24‐36 weeks Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Adverse events Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Withdrawal due to adverse event Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 2. Methotrexate versus 6‐MP or Azathioprine
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Comparison 3. Methotrexate versus 5‐ASA

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure to enter remission or possible remission at 30 weeks Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Withdrawal due to adverse event Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 3. Methotrexate versus 5‐ASA
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Comparison 4. Methotrexate and Infliximab versus Infliximab

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure to enter remission at 14 weeks or 24 weeks Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Adverse events Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Serious adverse events Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Withdrawals due to adverse event Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 4. Methotrexate and Infliximab versus Infliximab
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