SynthesisDigestive diseases and sciences2011
Relapse rate following azathioprine withdrawal in maintaining remission for Crohn's disease: a meta-analysis.
Synthesis in Digestive diseases and sciences, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Withdrawal of immunosuppressant or biologic therapy for patients with quiescent Crohn's disease.The Cochrane database of systematic reviews · 2018Pooled it
- Patients with Crohn's Disease Are More Likely to Remain on Biologics than Immunomodulators: A Meta-Analysis of Treatment Durability.Digestive diseases and sciences · 2015Pooled it
- Withdrawal of long-term maintenance treatment with azathioprine tends to increase relapse risk in patients with Crohn's disease.Digestive diseases and sciences · 2015Trial
- Relapse Rates and Predictors Following Azathioprine Withdrawal in Inflammatory Bowel Disease: A Systematic Review, Meta-Analysis, and Meta-Regression.Journal of clinical medicine · 2025Review
- Common Mistakes in Managing Patients with Inflammatory Bowel Disease.Journal of clinical medicine · 2024Review
- Azathioprine promotes intestinal epithelial cell differentiation into Paneth cells and alleviates ileal Crohn's disease severity.Scientific reports · 2024Article
- Discontinuation of therapy in inflammatory bowel disease: Current views.World journal of clinical cases · 2024Review
- Clinical Considerations Regarding the Use of Thiopurines in Older Patients with Inflammatory Bowel Disease.Drugs & aging · 2021Review
- Management of Crohn Disease: A Review.JAMA · 2021Review
- Thiopurine Methyltransferase Activity and Thiopurine Metabolites in Inflammatory Bowel Disease.Crohn's & colitis 360 · 2020Article
- Cancer Risk in Pediatric-Onset Inflammatory Bowel Disease.Frontiers in pediatrics · 2020Review
- Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials.Annals of the rheumatic diseases · 2019Article
- Use of Thiopurines in Inflammatory Bowel Disease: A Consensus Statement by the Korean Association for the Study of Intestinal Diseases (KASID).Intestinal research · 2015Review
- Indian Society of Gastroenterology consensus statements on Crohn's disease in India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2015Article
- Thiopurine withdrawal during sustained clinical remission in inflammatory bowel disease: relapse and recapture rates, with predictive factors in 237 patients.Alimentary pharmacology & therapeutics · 2014Article
- Optimization of the treatment with immunosuppressants and biologics in inflammatory bowel disease.World journal of gastroenterology · 2014Review
- Use of thiopurines in inflammatory bowel disease: Safety issues.World journal of gastrointestinal pharmacology and therapeutics · 2014Review
- A survey of current practices used to maintain surgically induced remission following intestinal resection for Crohn's disease.International journal of colorectal disease · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe duration of use of azathioprine (Aza) and 6-mercaptopurine (6-MP) for maintaining remission for Crohn's disease is debatable.
aimTo examine whether Aza/6-MP can be safely withdrawn in patients with Crohn's disease who have been in remission.
methodsThe following databases were searched: MEDLINE (1950-September 2010), EMBASE (1980-September 2010), CINHAL (1981-September 2010), PubMed (1950-September 2010), and the Cochrane Central Register of Controlled Trials (CENTRAL). Randomised controlled and cohort studies comparing azathioprine continuation versus placebo or no treatment were eligible for inclusion. Primary outcomes were relapse rate after discontinuation of Aza/6-MP at 6, 12, and 18 months, and 5 and 10 years.
resultsFive studies, with 256 patients and 168 controls, met the inclusion criteria. Stopping azathioprine/6-MP was found to significantly increase the risk of relapse at 6, 12, and 18 months with pooled odds ratios of 0.22 (95% CI 0.09-0.53), 0.25 (95% CI 0.11-0.56), and 0.35 (95% CI 0.21-0.6), respectively. Two trials examined relapse rate at 5 years with pooled OR 0.53 (95% CI 0.13-2.21). No trials looking at relapse rates beyond 5 years were identified.
conclusionsThere is a clear benefit of continuing Aza/6-MP for at least 18 months to maintain remission for Crohn's disease patients who established remission. There is not enough evidence to provide clear guidance on whether or not to continue Aza/6-MP treatment beyond 18 months. Well-designed randomised controlled trials addressing this issue are needed.
Indexed as
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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.