Cochrane · systematic review · CD000296
Budesonide for induction of remission in Crohn's disease
Rezaie, A, Kuenzig, ME, Benchimol, EI, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
22
current version
GRADE rated
22
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 4.5%Low 9 · 40.9%Moderate 12 · 54.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Budesonide 3 mg compared to placebo for induction of remission in Crohn's disease
Population: Patients with active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of clinical remission (CDAI < 150) ‐ 8 weeks Budesonide 3 mg vs placebo | RR 1.67 [0.92, 3.02] | 1 study · 133 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Budesonide 3 mg vs placebo | RR 0.66 [0.11, 3.8] | 1 study · 133 participants | Low Downgraded: imprecision |
Withdrawal due to disease worsening Budesonide 3 mg vs placebo | RR 0.92 [0.64, 1.33] | 1 study · 133 participants | Moderate Downgraded: imprecision |
Corticosteroid related adverse events Budesonide 3 mg vs placebo | RR 0.58 [0.29, 1.17] | 1 study · 133 participants | Low Downgraded: imprecision |
Budesonide 9 mg compared to placebo for induction of remission in Crohn's disease
Population: Patients with active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of clinical remission (CDAI < 150) ‐ 8 weeks Budesonide 9 mg vs placebo | RR 1.93 [1.37, 2.73] | 3 studies · 379 participants | Moderate Downgraded: imprecision |
Clinical improvement (decrease in CDAI > 100 or total CDAI < 150) ‐ 8 weeks Budesonide 9 mg vs placebo | RR 1.46 [1.03, 2.07] | 2 studies · 252 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Budesonide 9 mg vs placebo | RR 1.14 [0.46, 2.79] | 3 studies · 379 participants | Low Downgraded: imprecision |
Withdrawal due to disease worsening Budesonide 9 mg vs placebo | RR 0.53 [0.22, 1.29] | 3 studies · 379 participants | Low Downgraded: imprecision, inconsistency |
Corticosteroid related adverse events Budesonide 9 mg vs placebo | RR 0.97 [0.76, 1.23] | 3 studies · 384 participants | Moderate Downgraded: imprecision |
Budesonide 15 mg compared to placebo for induction of remission in Crohn's disease
Population: Patients with active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of clinical remission (CDAI < 150) ‐ 8 weeks Budesonide 15 mg vs placebo | RR 2.25 [1.35, 3.76] | 2 studies · 181 participants | Moderate Downgraded: imprecision |
Clinical improvement (decrease in CDAI > 100 or total CDAI <= 150) ‐ 8 weeks Budesonide 15 mg vs placebo | RR 2.34 [0.83, 6.63] | 1 study · 51 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Budesonide 15 mg vs placebo | RR 1.55 [0.45, 5.34] | 2 studies · 181 participants | Low Downgraded: imprecision |
Withdrawal due to disease worsening Budesonide 15 mg vs placebo | RR 0.57 [0.36, 0.89] | 2 studies · 181 participants | Moderate Downgraded: imprecision |
Corticosteroid related adverse events Budesonide 15 mg vs placebo | RR 1.4 [0.84, 2.34] | 2 studies · 181 participants | Moderate Downgraded: imprecision |
Budesonide 9 mg compared to conventional steroids for induction of remission in Crohn's disease
Population: Patients with active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of clinical remission (CDAI < 150) ‐ 8 weeks Budesonide 9 mg vs conventional steroids | RR 0.85 [0.75, 0.97] | 8 studies · 750 participants | Moderate Downgraded: risk of bias |
Withdrawal due to adverse events Budesonide 9 mg vs conventional steroids | RR 0.57 [0.18, 1.84] | 5 studies · 522 participants | Low Downgraded: imprecision |
Withdrawal due to disease worsening Budesonide 9 mg vs conventional steroids | RR 1 [0.07, 14.55] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Budesonide 9 mg compared to mesalamine for induction of remission in Crohn's disease
Population: Patients with active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of clinical remission (CDAI < 150) ‐ 8 weeksThomsen 1998 Budesonide 9 mg vs mesalamine | RR 1.63 [1.23, 2.16] | 1 study · 182 participants | Moderate Downgraded: imprecision |
Induction of clinical remission (CDAI < 150) ‐ 8 weeksTromm 2011 Budesonide 9 mg vs mesalamine | RR 1.12 [0.95, 1.32] | 1 study · 307 participants | Moderate Downgraded: imprecision |
Clinical improvement (decrease in CDAI > 100 or total CDAI < 150) Budesonide 9 mg vs mesalamine | RR 1.18 [0.99, 1.42] | 2 studies · 489 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Budesonide 9 mg vs mesalamine | RR 0.43 [0.18, 1.03] | 2 studies · 489 participants | Low Downgraded: imprecision |
Withdrawal due to disease worsening Budesonide 9 mg vs mesalamine | RR 0.35 [0.18, 0.69] | 1 study · 182 participants | Moderate Downgraded: imprecision |