Oral 5-aminosalicylic acid for maintenance of surgically-induced remission in Crohn's disease

5-ASA preparations appear to be effective in maintaining surgically induced remission compared to placebo in patients with Crohn’s disease, but the benefit is modest (NNT 16 to 19).

The quality of evidence is downgraded by study limitations (inadequate or unclear allocation concealment).

Summary

A Cochrane review included 9 studies with a total of 1039 patients to evaluate the efficacy and safety of 5-ASA agents for the maintenance of surgically-induced remission in Crohn’s disease in adults.

Seven studies compared oral 5-ASA with placebo and two compared oral 5-ASA with purine antimetabolites (azathioprine or 6-mercaptopurine). 5-ASA was significantly more effective than placebo for preventing relapse (OR 0.68; 95% CI 0.52 to 0.90), but the number-needed-to-treat (NNT) was 16 to 19. There was no statistically significant heterogeneity among the trials comparing 5-ASA with placebo (P=0.47). No statistically significant difference in adverse events was found for 5-ASA versus placebo (OR 1.02; 95%CI 0.60 to 1.76). No statistically significant difference was found between 5-ASA and purine antimetabolites for preventing relapses (OR 1.08; 95% CI 0.63 to 1.85).

Clinical comments

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Ədəbiyyat

1. Gordon M, Naidoo K, Thomas AG et al. Oral 5-aminosalicylic acid for maintenance of surgically-induced remission in Crohn's disease. Cochrane Database Syst Rev 2011;(1):CD008414.