Primary Biliary Cirrhosis Treated with Low-Dose Oral Pulse Methotrexate

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Abstract
There is no totally effective treatment for primary biliary cirrhosis, a chronic, progressive liver disease that most often affects middle-aged women (1). Patients treated with colchicine show improved results on biochemical tests of liver function, and colchicine appears to slow the progression of this disease, but it does not improve symptoms or liver histology (2, 3). We recently reported (4) that low-dose oral pulse methotrexate produced clinical, biochemical, and histologic remission in two patients with primary sclerosing cholangitis. Because there are clinical and immunologic similarities between primary sclerosing cholangitis and primary biliary cirrhosis (5), we studied two women with symptomatic