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Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease

  1. Nilesh Chande1,*,
  2. David J Tsoulis2,
  3. John K MacDonald2

Editorial Group: Cochrane IBD Group

Published Online: 30 APR 2013

Assessed as up-to-date: 13 JUN 2012

DOI: 10.1002/14651858.CD000545.pub4


How to Cite

Chande N, Tsoulis DJ, MacDonald JK. Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD000545. DOI: 10.1002/14651858.CD000545.pub4.

Author Information

  1. 1

    London Health Sciences Centre - Victoria Hospital, London, Ontario, Canada

  2. 2

    Robarts Research Institute, Robarts Clinical Trials, London, Ontario, Canada

*Nilesh Chande, London Health Sciences Centre - Victoria Hospital, Room E1-423A, 800 Commissioners Road East, London, Ontario, N6A 5W9, Canada. nchande2@uwo.ca.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 30 APR 2013

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This is not the most recent version of the article. View current version (26 OCT 2016)

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ardizzone 2003 {published data only}
  • Ardizzone S, Bollani S, Manzionna G, Imbesi V, Colombo E, Bianchi Porro G. Comparison between methotrexate and azathioprine in the treatment of chronic active Crohn's disease: a randomized, investigator-blind study. Digestive and Liver Disease 2003;35(9):619-27.
Candy 1995 {published data only}
Colombel 2010 {published data only}
  • Colombel J, Sandborn W, Reinisch W, Mantzaris G, Kornbluth A, Rachmilewitz D, et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. New England Journal of Medicine 2010;362(15):1383-95.
  • Colombel J, Sandborn W, Reinisch W, Mantzaris G, Kornbluth A, Rachmilewitz D, et al. Supplementary Appendix. New England Journal of Medicine 2010;362.
Ewe 1993 {published data only}
  • Ewe K, Press AG, Singe CC, Stufler M, Ueberschaer B, Hommel G, et al. Azathioprine combined with prednisolone or monotherapy with prednisolone in active Crohn's disease. Gastroenterology 1993;105(2):367-72.
Klein 1974 {published data only}
  • Klein M, Binder HJ, Mitchell M, Aaronson R, Spiro H. Treatment of Crohn's disease with azathioprine: a controlled evaluation. Gastroenterology 1974;66(5):916-22.
Mantzaris 2004 {published data only}
  • Mantzaris GJ, Ployzou P, Karagiannidis A, Christidou A, Koilakou S, Tsounis D, et al. A prospective, randomized trial of infliximab and azathioprine for the induction and maintenance of remission of steroid-dependent Crohn's disease. Gastroenterology 2004;126(4 Suppl 2):A54.
Maté-Jiménez 2000 {published data only}
  • Maté-Jiménez J, Hermida C, Cantero-Perona J, Moreno-Otero R. 6-mercaptopurine or methotrexate added to prednisone induces and maintains remission in steroid-dependent inflammatory bowel disease. European Journal of Gastroenterology and Hepatology 2000;12(11):1227-33.
Oren 1997 {published data only}
  • Oren R, Moshkowitz M, Odes S, Becker S, Keter D, Pomeranz I, et al. Methotrexate in chronic active Crohn's disease: a double-blind, randomized, Israeli multicenter trial. American Journal of Gastroenterology 1997;92(12):2203-9.
Present 1980 {published data only}
  • Present DH, Korelitz BI, Wisch N, Glass JL, Sachar DB, Pasternack BS. Treatment of Crohn's disease with 6-mercaptopurine. A long-term, randomized, double-blind study. New England Journal of Medicine 1980;302(18):981-7.
Reinisch 2008 {published data only}
  • Reinisch W, Panés J, Lémann M, Schreiber S, Feagan B, Schmidt S, et al. A multicenter, randomized, double-blind trial of everolimus versus azathioprine and placebo to maintain steroid-induced remission in patients with moderate-to-severe active Crohn's disease. American Journal of Gastroenterology 2011;103(9):2284-92.
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Rhodes 1971 {published data only}
Summers 1979 {published data only}
  • Mekhjian HS, Switz DM, Melnyk CS, Rankin GB, Brooks RK. Clinical features and natural history of Crohn's disease. Gastroenterology 1979;77(4 Pt 2):898-906.
  • Singleton J, Law D, Kelley M, Mekhjian H, Sturdevant R. National Cooperative Crohn's Disease Study: Adverse Reactions to Study Drugs. Gastroenterology 1979;77(4 Pt 2):870-82.
  • Summers RW, Switz DM, Sessions JT, Becktel JM, Best WR, Kern F, et al. National Cooperative Crohn's Disease Study: results of drug treatment. Gastroenterology 1979;77(4 Pt 2):847-69.
  • Winship DH, Summers RW, Singleton JW, Best WR, Becktel JM, Lenk LF, Kern F Jr. National Cooperative Crohn's Disease Study: study design and conduct of the study. Gastroenterology 1979;77(4 Pt 2):829-42.
Willoughby 1971 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Chebli 2007 {published data only}
  • Chebli JMF, Gaburri PD, De Souza AFM, Pinto ALT, Chebli LA, Felga GEG, et al. Long-term results with azathioprine therapy in patients with corticosteroid-dependent Crohn’s disease: Open-label prospective study. Gastroenterology 2007;22:268-74.
Cosnes 2012 {published data only}
  • Cosnes J, Bourrier A, Bouhnik Y, Laharie D, Nahon S, Bonnet J, et al. Accelerated step-care therapy with early azathioprine (AZA) vs. conventional step-care therapy in Crohn's disease. A randomized study. Gastroenterology 2012;142(5 Suppl 1):S161.
D'Haens 2008 {published data only}
  • D'Haens G, Baert F, van Assche G, Caenepeel P, Vergauwe P, Tuynman H, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet 2008;371:660-7.
Dejaco 2003 {published data only}
Hinterleitner 1997 {published data only}
  • Hinterleitner T, Petritsch W, Aichbichler B, Fickert P, Ranner G, Krejs G. Combination of cyclosporine, azathioprine and prednisolone for perianal fistulas in Crohn's disease. Zeitschrift für Gastroenterologie 1997;35(8):603-8.
Lémann 2006 {published data only}
  • Lémann M, Mary JY, Duclos B, Veyrac M, Dupas JL, Delchier JC, et al. Infliximab plus azathioprine for steroid-dependent Crohn’s disease patients: A randomized placebo-controlled trial. Gastroenterology 2006;130:1054–61.
Ludwig 1999 {published data only}
  • Ludwig D, Strange EF. Efficacy of azathioprine in the treatment of chronic active Crohn's disease: prospective one-year follow-up study. German Imurek Study Group. Zeitschrift für Gastroenterologie 1999;37(11):1085-91.
Mantzaris 2009 {published data only}
Markowitz 2000 {published data only}
Miehsler 2001 {published data only}
  • Miehsler W, Reinisch W, Moser G, Gangl A, Vogelsang H. Is mycophenolate mofetil an effective alternative in azathioprine-intolerant patients with chronic active Crohn's disease?. American Journal of Gastroenterology 2001;96(3):782-7.
    Direct Link:
Neurath 1999 {published data only}
  • Neurath MF, Wanitschke R, Peters M, Krummenauer F, Meyer Zum Buschenfelde KH, Schlaak JF. Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn's disease. Gastroenterology 1998;114(4 Pt 2):A487.
  • Neurath MF, Wanitschke R, Peters M, Krummenauer F, Meyer zum Buschenfelde KH, Schlaak JF. Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn's disease. Gut 1999;44(5):625-8.
Reinshagen 2007 {published data only}
  • Reinshagen M, Schütz E, Armstrong VW, Behrens C, von Tirpitz C, Stallmach A, et al. 6-Thioguanine nucleotide–adapted azathioprine therapy does not lead to higher remission rates than standard therapy in chronic active Crohn disease: results from a randomized, controlled, open trial. Clinical Chemistry 2007;53(7):1306–14.
Watson 1974 {published data only}
  • Watson WC, Bukosdky M. Azathioprine in management of Crohn's disease: A randomized cross-over study. Gastroenterology 1974;66:796 (Abstract).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Alstead 1990
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Bouhnik 1996
  • Bouhnik Y, Lemann M, Mary JY, Scemama G, Tai R, Matuchansky C, et al. Long-term follow-up of patients with Crohn's disease treated with azathioprine or 6-mercaptopurine. Lancet 1996;347(8996):215-9.
Brooke 1969
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Brown 1970
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Colonna 1994
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Connell 1993
Connell 1994
D'Haens 1995
  • D'Haens G, Callens J, Hiele M, Peeters M, Rutgeerts P. Reduction of neutrophil and not lymphocyte count is associated with favourable response to azathioprine therapy in refractory Crohn's disease. Gastroenterology 1995;108:A809.
D'Haens 1997
Drucker 1970
Fausa 1971
Fraser 2002
Gisbert 2008
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Haber 1986
Hanauer 2004
  • Hanauer SB, Wagner CL, Bala M, Mayer L, Travers S, Diamond RH, et al. Incidence and importance of antibody responses to infliximab after maintenance or episodic treatment in Crohn's disease. Clinical Gastroenterology and Hepatology 2004;2(7):542-53.
Higgins 2003
Higgins 2011
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Javett 1972
Kessler 1995
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Korelitz 1981
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Korelitz 1985
Korelitz 1993
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Lemann 1990
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Lennard 1983
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Nyman 1985
O'Brien 1991
Papp 1974
Patterson 1971
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Perrault 1991
Present 1989
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Rhodes 1970
Rosman 1973
Sahasranaman 2008
Sandborn 1995
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Sandborn 1999
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Schünemann 2011
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Shah 1991
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Van Os 1996
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Verhave 1990
Wallensten 1972
Weinshilboum 1980
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Zins 1997

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Pearson 1995
Prefontaine 2010