Cochrane · systematic review · CD008414
Oral 5‐aminosalicylic acid for maintenance of surgically‐induced remission in Crohn's disease
Gjuladin‐Hellon, T, Gordon, M, Iheozor‐Ejiofor, Z, et al. · Cochrane Database of Systematic Reviews · 2019 · 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
42
current version
GRADE rated
27
No studies
15
Included studies
NR
No studies 15 · 35.7%Ungraded 0 · 0%Very low 14 · 33.3%Low 10 · 23.8%Moderate 3 · 7.1%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
5‐ASA compared to no treatment for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse 5‐ASA vs no treatment | RR 0.71 [0.46, 1.1] | 110 participants | Low Downgraded: risk of bias |
Endoscopic recurrence 5‐ASA vs no treatment | no estimate extracted | NR | No studies |
Radiologic relapse 5‐ASA vs no treatment | no estimate extracted | NR | No studies |
Adverse events 5‐ASA vs no treatment | RR 5 [0.25, 101.81] | 110 participants | Very low Downgraded: risk of bias |
Serious adverse events 5‐ASA vs no treatment | no estimate extracted | NR | No studies |
Withdrawal due to adverse events 5‐ASA vs no treatment | RR 5 [0.25, 101.81] | 1 study · 110 participants | Very low Downgraded: risk of bias |
Health related quality of life 5‐ASA vs no treatment | no estimate extracted | NR | No studies |
5‐ASAs compared to placebo for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse 5‐ASAs vs placebo | RR 0.83 [0.72, 0.96] | 5 studies · 730 participants | Moderate Downgraded: imprecision |
Endoscopic recurrence 5‐ASAs vs placebo | RR 0.83 [0.56, 1.24] | 3 studies · 537 participants | Very low Downgraded: risk of bias, inconsistency |
Radiologic relapse 5‐ASAs vs placebo | no estimate extracted | NR | No studies |
Adverse events 5‐ASAs vs placebo | RR 1.07 [0.6, 1.91] | 4 studies · 466 participants | Low Downgraded: inconsistency |
Serious adverse events 5‐ASAs vs placebo | RR 1.06 [0.44, 2.59] | 3 studies · 577 participants | Low Downgraded: imprecision |
Withdrawal due to adverse events 5‐ASAs vs placebo | RR 1.5 [0.71, 3.19] | 3 studies · 297 participants | Low Downgraded: imprecision |
Health related quality of life 5‐ASAs vs placebo | no estimate extracted | NR | No studies |
High dose 5‐ASA compared to low dose 5‐ASA for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse High dose 5‐ASA vs low dose 5‐ASA | RR 0.65 [0.38, 1.13] | 1 study · 206 participants | Moderate Downgraded: imprecision |
Endoscopic recurrence High dose 5‐ASA vs low dose 5‐ASA | RR 0.79 [0.6, 1.04] | 1 study · 206 participants | Moderate Downgraded: imprecision |
Radiologic relapse High dose 5‐ASA vs low dose 5‐ASA | no estimate extracted | NR | No studies |
Adverse events High dose 5‐ASA vs low dose 5‐ASA | RR 1.04 [0.15, 7.24] | 1 study · 206 participants | Low Downgraded: imprecision |
Serious adverse events High dose 5‐ASA vs low dose 5‐ASA | no estimate extracted | NR | No studies |
Withdrawal due to adverse events High dose 5‐ASA vs low dose 5‐ASA | RR 1.04 [0.15, 7.24] | 1 study · 206 participants | Low Downgraded: imprecision |
Health related quality of life High dose 5‐ASA vs low dose 5‐ASA | no estimate extracted | NR | No studies |
5‐ASA compared to purine antimetabolites for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse 5‐ASA vs purine antimetabolites | RR 0.9 [0.76, 1.07] | 4 studies · 347 participants | Low Downgraded: risk of bias |
Endoscopic recurrence 5‐ASA vs purine antimetabolites | RR 1.29 [0.86, 1.94] | 1 study · 35 participants | Very low Downgraded: risk of bias |
Radiologic relapse 5‐ASA vs purine antimetabolites | RR 1.09 [0.78, 1.52] | 1 study · 35 participants | Very low Downgraded: risk of bias |
Adverse events 5‐ASA vs purine antimetabolites | RR 1.11 [0.97, 1.27] | 5 studies · 425 participants | Low Downgraded: risk of bias |
Serious adverse events 5‐ASA vs purine antimetabolites | RR 0.3 [0.11, 0.8] | 3 studies · 311 participants | Very low Downgraded: risk of bias |
Withdrawal due to adverse events 5‐ASA vs purine antimetabolites | RR 0.48 [0.28, 0.83] | 5 studies · 425 participants | Low Downgraded: risk of bias |
Health related quality of life 5‐ASA vs purine antimetabolites | RR 1.42 [0.27, 7.46] | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |
5‐ASAs compared to anti TNF‐ɑ for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse 5‐ASAs vs anti TNF‐ɑ | RR 4 [1.01, 15.84] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Endoscopic recurrence 5‐ASAs vs anti TNF‐ɑ | RR 13.33 [1.98, 89.95] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Radiologic relapse 5‐ASAs vs anti TNF‐ɑ | RR 13.33 [1.98, 89.95] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Adverse events 5‐ASAs vs anti TNF‐ɑ | RR 1.13 [0.75, 1.71] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Serious adverse events 5‐ASAs vs anti TNF‐ɑ | no estimate extracted | NR | No studies |
Withdrawal due to adverse events 5‐ASAs vs anti TNF‐ɑ | RR 0.3 [0.01, 6.84] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Health related quality of life 5‐ASAs vs anti TNF‐ɑ | RR 0.19 [0.07, 0.54] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Sulphasalazine compared to placebo for maintenance of surgically‐induced remission in Crohn's disease
Population: people with surgically‐induced remission in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse Sulphasalazine vs placebo | RR 0.88 [0.56, 1.38] | 2 studies · 298 participants | Low Downgraded: risk of bias |
Endoscopic recurrence Sulphasalazine vs placebo | no estimate extracted | NR | No studies |
Radiologic relapse Sulphasalazine vs placebo | no estimate extracted | NR | No studies |
Adverse events Sulphasalazine vs placebo | no estimate extracted | NR | No studies |
Serious adverse events Sulphasalazine vs placebo | no estimate extracted | NR | No studies |
Withdrawal due to adverse events Sulphasalazine vs placebo | RR 0.35 [0.01, 8.38] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision |
Health related quality of life (HRQL) Sulphasalazine vs placebo | no estimate extracted | NR | No studies |