Evidence map›Paper›PMID 30542812›Full record

ArticleDigestive diseases and sciences2019

Usefulness of Thiopurine Monotherapy for Crohn's Disease in the Era of Biologics: A Long-Term Single-Center Experience.

Cristina Suárez Ferrer, Yago González-Lama, Irene González-Partida, Marta Calvo Moya, Isabel Vera Mendoza, Virginia Matallana Royo, Juan Arevalo Serrano, Luis Abreu Garcia

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Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Perianal fistulizing Crohn's disease: Clinical practice update from Colitis and Crohn's Foundation (India).Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Guideline
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Cristina Suárez FerrerIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Yago González-LamaIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Irene González-PartidaIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Marta Calvo MoyaIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Isabel Vera MendozaIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Virginia Matallana RoyoIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Juan Arevalo SerranoInternal Medicine Department, Principe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain.
Luis Abreu GarciaIBD Unit, Digestive Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain. luisabreugarcia@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThiopurines are classically used in Crohn's disease (CD). Treatment fails in a proportion of patients either due to adverse events (AE) or lack of efficacy. Increasing use of anti-TNFα biologic drugs may have had impact on thiopurines usage.

aimTo evaluate the evolving use of azathioprine (AZA) monotherapy in the era of biologics.

methodsThe study retrospectively analyzed clinical records of all CD patients who started treatment with AZA monotherapy at our center since 1990. Dates of starting AZA and treatment failure (TF) were collected. We defined AZA TF if it was withdrawn due to lack of efficacy or AE, or biologics were added.

resultsA total of 383 patients were included: 46.5% were males and mean age was 31 (range 17-84) years. Median follow-up was 43 (range 0.2-289) months. Overall, 147 patients (38%) experienced TF. Median cumulative survival time of AZA was 126 (95% CI 105-147) months. Proportion of patients with AZA TF increased along time: 7 patients in 1990-1995 (4.7% of all TF); 8 in 1996-2000 (5.4%); 22 in 2001-2005(15%); 41 in 2006-2010 (28%); 69 in 2011-2014 (47%) (p = 0.04). 7%, 21%, 4%, 45%, and 33.3% of patients moved to biologics in each period, respectively (χ

conclusionAn important proportion of CD patients under AZA monotherapy experienced TF in our experience. Although AZA monotherapy remains useful for CD in the era of biologics, current clinical practice is shifting to anti-TNFα biologic drugs in an increasing proportion of patients.

Indexed as

AdolescentAdultAgedAged, 80 and overAzathioprineBiological ProductsCrohn DiseaseFemaleGastrointestinal AgentsHumansImmunosuppressive AgentsMaleMiddle AgedRetrospective StudiesRisk FactorsSpainAzathioprineBiological ProductsGastrointestinal AgentsImmunosuppressive AgentsCrohn’s diseaseThiopurine IBDThiopurine maintenance in Crohn’s disease

Identifiers

PMID30542812

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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.