Cochrane · systematic review · CD000543
Oral 5‐aminosalicylic acid for induction of remission in ulcerative colitis
Murray, A, Nguyen, TM, Parker, CE, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
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
28
current version
GRADE rated
23
No studies
5
Included studies
NR
No studies 5 · 17.9%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 21.4%Moderate 12 · 42.9%High 5 · 17.9%
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
Current version onlyOral 5‐ASA versus placebo for induction of remission in ulcerative colitis
Population: People with active mild‐to‐moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce complete global or clinical remission Oral 5‐ASA vs placebo | RR 0.86 [0.82, 0.89] | 11 studies · 2387 participants | High |
Failure to induce global or clinical improvement Oral 5‐ASA vs placebo | RR 0.68 [0.61, 0.75] | 14 studies · 2256 participants | Moderate Downgraded: inconsistency |
Failure to induce endoscopic remission Oral 5‐ASA vs placebo | RR 0.77 [0.67, 0.89] | 4 studies · 1154 participants | Moderate Downgraded: inconsistency |
Failure to adhere to medication regimen Oral 5‐ASA vs placebo | no estimate extracted | NR | No studies |
Adverse events Oral 5‐ASA vs placebo | RR 0.95 [0.85, 1.07] | 8 studies · 1218 participants | High |
Serious adverse events Oral 5‐ASA vs placebo | RR 0.53 [0.18, 1.56] | 4 studies · 746 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs placebo | RR 0.72 [0.54, 0.97] | 13 studies · 2372 participants | Moderate Downgraded: imprecision |
Oral 5‐ASA versus SASP for induction of remission in ulcerative colitis
Population: People with active mild‐to‐moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs SASP | RR 0.9 [0.77, 1.04] | 8 studies · 526 participants | Moderate Downgraded: imprecision |
Failure to induce global or clinical improvement Oral 5‐ASA vs SASP | RR 0.88 [0.76, 1.01] | 14 studies · 1053 participants | High |
Failure to induce endoscopic remission Oral 5‐ASA vs SASP | no estimate extracted | NR | No studies |
Failure to adhere to medication regimen Oral 5‐ASA vs SASP | no estimate extracted | NR | No studies |
Adverse events Oral 5‐ASA vs SASP | RR 0.48 [0.36, 0.63] | 12 studies · 909 participants | Moderate Downgraded: imprecision |
Serious adverse events Oral 5‐ASA vs SASP | RR 1.36 [0.28, 6.52] | 2 studies · 107 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs SASP | RR 0.4 [0.24, 0.68] | 10 studies · 640 participants | Moderate Downgraded: imprecision |
Once daily dosing versus conventional dosing for induction of remission in ulcerative colitis
Population: People with active mild‐to‐moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Once daily dosing vs conventional dosing | RR 0.99 [0.93, 1.06] | 5 studies · 1761 participants | High |
Failure to induce global or clinical improvement Once daily dosing vs conventional dosing | RR 0.74 [0.49, 1.1] | 3 studies · 564 participants | Moderate Downgraded: imprecision |
Failure to induce endoscopic remission Once daily dosing vs conventional dosing | RR 1.02 [0.98, 1.07] | 1 study · 817 participants | High |
Failure to adhere to medication regimen Once daily dosing vs conventional dosing | RR 1.36 [0.64, 2.86] | 2 studies · 358 participants | Low Downgraded: imprecision |
Adverse events Once daily dosing vs conventional dosing | RR 1.02 [0.89, 1.18] | 4 studies · 1586 participants | Moderate Downgraded: imprecision |
Serious adverse events Once daily dosing vs conventional dosing | RR 1.34 [0.68, 2.66] | 4 studies · 1586 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Once daily dosing vs conventional dosing | RR 0.89 [0.54, 1.49] | 5 studies · 1757 participants | Low Downgraded: imprecision |
Oral 5‐ASA versus comparator 5‐ASA for induction of remission in ulcerative colitis
Population: People with active mild‐to‐moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.86, 1.02] | 11 studies · 1968 participants | Moderate Downgraded: risk of bias |
Failure to induce global or clinical improvement Oral 5‐ASA vs comparator 5‐ASA | RR 0.89 [0.77, 1.01] | 8 studies · 1647 participants | Moderate Downgraded: risk of bias, imprecision |
Failure to induce endoscopic remission Oral 5‐ASA vs comparator 5‐ASA | no estimate extracted | NR | No studies |
Failure to adhere to medication regimen Oral 5‐ASA vs comparator 5‐ASA | no estimate extracted | NR | No studies |
Adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 1.01 [0.92, 1.12] | 9 studies · 1576 participants | Moderate Downgraded: risk of bias, imprecision |
Serious adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 0.59 [0.22, 1.56] | 4 studies · 677 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.57, 1.54] | 9 studies · 1489 participants | Moderate Downgraded: imprecision |
Oral 5‐ASA versus placebo for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs placebo | RR 0.86 [0.82, 0.89] | 11 studies · 2387 participants | High |
Failure to induce clinical improvement Oral 5‐ASA vs placebo | RR 0.68 [0.61, 0.75] | 15 studies · 2256 participants | Moderate Downgraded: inconsistency |
Adverse events Oral 5‐ASA vs placebo | RR 0.95 [0.85, 1.07] | 8 studies · 1218 participants | High |
Withdrawal due to adverse events Oral 5‐ASA vs placebo | RR 0.88 [0.62, 1.24] | 12 studies · 2091 participants | Moderate Downgraded: imprecision |
Oral 5‐ASA versus SASP for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs SASP | RR 0.9 [0.77, 1.04] | 8 studies · 526 participants | Moderate Downgraded: imprecision |
Failure to induce clinical improvement Oral 5‐ASA vs SASP | RR 0.88 [0.76, 1.01] | 14 studies · 1053 participants | High |
Adverse events Oral 5‐ASA vs SASP | RR 0.48 [0.36, 0.63] | 12 studies · 909 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs SASP | RR 0.4 [0.24, 0.68] | 10 studies · 640 participants | Moderate Downgraded: imprecision |
Once daily dosing versus conventional dosing for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Once daily dosing vs conventional dosing | RR 0.94 [0.83, 1.07] | 4 studies · 944 participants | High |
Failure to induce clinical improvement Once daily dosing vs conventional dosing | RR 0.87 [0.68, 1.1] | 2 studies · 358 participants | Moderate Downgraded: imprecision |
Failure to adhere to medication regimen Once daily dosing vs conventional dosing | RR 1.36 [0.64, 2.86] | 2 studies · 358 participants | Low Downgraded: imprecision |
Adverse events Once daily dosing vs conventional dosing | RR 0.88 [0.73, 1.07] | 3 studies · 769 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Once daily dosing vs conventional dosing | RR 0.58 [0.23, 1.44] | 4 studies · 940 participants | Low Downgraded: imprecision |
Oral 5‐ASA versus comparator 5‐ASA for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.86, 1.02] | 11 studies · 1968 participants | Moderate Downgraded: risk of bias |
Failure to induce clinical improvement Oral 5‐ASA vs comparator 5‐ASA | RR 0.89 [0.77, 1.01] | 8 studies · 1647 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 1.01 [0.92, 1.12] | 9 studies · 1576 participants | Moderate Downgraded: risk of bias, imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.57, 1.54] | 9 studies · 1489 participants | Moderate Downgraded: imprecision |
High dose oral 5‐ASA versus low dose 5‐ASA for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission High dose oral 5‐ASA vs low dose 5‐ASA | RR 1.03 [0.82, 1.29] | 2 studies · 194 participants | Moderate Downgraded: imprecision |
Failure to induce clinical improvement High dose oral 5‐ASA vs low dose 5‐ASA | RR 0.89 [0.78, 1.01] | 3 studies · 1459 participants | High |
Oral 5‐ASA versus placebo for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs placebo | RR 0.86 [0.81, 0.91] | 8 studies · 1843 participants | High |
Failure to induce clinical improvement Oral 5‐ASA vs placebo | RR 0.68 [0.6, 0.76] | 13 studies · 1954 participants | High |
Adverse events Oral 5‐ASA vs placebo | RR 0.97 [0.85, 1.11] | 6 studies · 916 participants | High |
Withdrawal due to adverse events Oral 5‐ASA vs placebo | RR 0.88 [0.62, 1.24] | 12 studies · 2091 participants | Moderate Downgraded: imprecision |
Oral 5‐ASA versus SASP for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs SASP | RR 0.9 [0.77, 1.04] | 8 studies · 526 participants | Moderate Downgraded: imprecision |
Failure to induce clinical improvement Oral 5‐ASA vs SASP | RR 0.88 [0.77, 1.01] | 13 studies · 1034 participants | High |
Adverse events Oral 5‐ASA vs SASP | RR 0.48 [0.37, 0.63] | 11 studies · 890 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs SASP | RR 0.4 [0.24, 0.69] | 9 studies · 621 participants | Moderate Downgraded: imprecision |
Once daily dosing versus conventional dosing for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Once daily dosing vs conventional dosing | RR 0.95 [0.85, 1.1] | 3 studies · 738 participants | Moderate Downgraded: imprecision |
Failure to induce clinical improvement Once daily dosing vs conventional dosing | RR 0.87 [0.68, 1.1] | 2 studies · 358 participants | Moderate Downgraded: imprecision |
Failure to adhere to medication regimen Once daily dosing vs conventional dosing | RR 1.36 [0.64, 2.86] | 2 studies · 358 participants | Moderate Downgraded: imprecision |
Adverse events Once daily dosing vs conventional dosing | RR 0.88 [0.7, 1.1] | 2 studies · 567 participants | Moderate Downgraded: imprecision |
Withdrawal due to adverse events Once daily dosing vs conventional dosing | RR 0.37 [0.1, 1.38] | 3 studies · 738 participants | Moderate Downgraded: imprecision |
Oral 5‐ASA versus comparator 5‐ASA for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.86, 1.02] | 11 studies · 1968 participants | Moderate Downgraded: risk of bias |
Failure to induce clinical improvement Oral 5‐ASA vs comparator 5‐ASA | RR 0.89 [0.77, 1.01] | 8 studies · 1647 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 1.01 [0.92, 1.12] | 9 studies · 1576 participants | Moderate Downgraded: risk of bias, imprecision |
Withdrawal due to adverse events Oral 5‐ASA vs comparator 5‐ASA | RR 0.94 [0.57, 1.54] | 9 studies · 1489 participants | Moderate Downgraded: imprecision |
High dose oral 5‐ASA versus low dose 5‐ASA for induction of remission in ulcerative colitis
Population: Patients with active mild to moderate ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to induce global or clinical remission High dose oral 5‐ASA vs low dose 5‐ASA | RR 1.03 [0.82, 1.29] | 2 studies · 194 participants | Moderate Downgraded: imprecision |
Failure to induce clinical improvement High dose oral 5‐ASA vs low dose 5‐ASA | RR 0.89 [0.78, 1.01] | 3 studies · 1459 participants | High |