Evidence map›Paper›PMID 10796482›Full record

SynthesisThe Cochrane database of systematic reviews2000

Azathioprine for maintaining remission of Crohn's disease.

D C Pearson, G R May, G Fick, L R Sutherland

Registry-linked trialAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02852694 (Risk-stratified Randomized Controlled Trial in Paediatric Crohn Disease), which is not on this map. Cited by 75 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02852694 phase4completednot on this mapstarted 2017, after this paper: background citation

Risk-stratified Randomized Controlled Trial in Paediatric Crohn Disease:Methotrexate Vs Azathioprine or Adalimumab for Maintaining Remission in Patients At Low or High Risk for Aggressive Disease Course, Respectively-a Treatment Strategy

TypeinterventionalSponsorPIBD-NetRan2017 to 2021Enrolled192ConditionsCrohn's DiseaseArmsMethotrexate, Adalimumab, Azathioprine / 6 Mercaptopurine
3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. ACG Clinical Guideline: Management of Crohn's Disease in Adults.The American journal of gastroenterology · 2018
    Guideline
  2. Guideline
  3. Pooled it
  4. Guideline
  5. Guideline
  6. Azathioprine for primary biliary cirrhosis.The Cochrane database of systematic reviews · 2007
    Pooled it
  7. Pooled it
  8. Guideline
  9. Corticosteroids for maintaining remission of Crohn's disease.The Cochrane database of systematic reviews · 2000
    Pooled it
  10. Trial
  11. Trial
  12. Article
  13. Observational
  14. Review
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

D C PearsonCommunity Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada, T2N 4N1. lsutherl@acs.ucalgary.ca
G R May
G Fick
L R Sutherland

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the effectiveness of azathioprine in maintaining remission of quiescent Crohn's disease. SEARCH STRATEGY: Pertinent studies were selected using the MEDLINE data base (1966 - May 1998), the Cochrane Controlled Trials Register, the Inflammatory Bowel Disease Trials Register, as well as abstracts from major gastrointestinal research meetings and references from published articles and reviews. SELECTION CRITERIA: Five randomized, double-blind, placebo-controlled trials of azathioprine therapy were identified. Two of these trials consisted solely of patients with quiescent Crohn's disease. Three trials had multiple therapeutic arms for both induction of remission and maintenance of remission. DATA COLLECTION AND ANALYSIS: Data were extracted by three independent observers (GRM, GF, LRS) based on the intention to treat principle. Peto odds ratios for the overall maintenance of remission, steroid sparing, and withdrawals due to adverse effects were calculated, and from these, 95% confidence intervals were derived. Numbers needed to treat or harm (NNT, NNH respectively) for the maintenance of remission, steroid sparing, and withdrawals due to adverse effects were also determined. MAIN

resultsAzathioprine had a positive effect on maintaining remission. The Peto odds ratio for maintenance of remission was 2.16 (CI 1.35 - 3.47) with an NNT of 7. A higher dose improved response. A steroid sparing effect was noted, with a Peto odds ratio of 5.22 (CI 1.06 - 25.68) and NNT of 3 for quiescent disease. The Peto odds ratio for withdrawals due to adverse events was 4.36 (CI 1.63 - 11.67), the NNH (Number Needed to Harm) was 19. REVIEWER'S

conclusionsAzathioprine is effective in maintaining remission. There is evidence for a steroid sparing effect.

Indexed as

AzathioprineCrohn DiseaseHumansImmunosuppressive AgentsMercaptopurineProdrugsAzathioprineImmunosuppressive AgentsMercaptopurineProdrugs

Identifiers

PMID10796482

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.