Cochrane · systematic review · CD008870
Aminosalicylates for induction of remission or response in Crohn's disease
Lim, WC, Wang, Y, MacDonald, JK, et al. · Cochrane Database of Systematic Reviews · 2016 · 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
20
current version
GRADE rated
20
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 20%Low 9 · 45%Moderate 7 · 35%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
Sulfasalazine compared to placebo for induction of remission or response in Crohn's disease
Population: patients with induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission (CDAI <150), therapeutic response (VHI decrease >=25%) or clinical improvement Sulfasalazine vs placebo | RR 1.52 [0.95, 2.43] | 3 studies · 289 participants | Low Downgraded: imprecision, inconsistency |
Induction of remission (CDAI <150) (Random Effects Model) Sulfasalazine vs placebo | RR 1.38 [1, 1.89] | 2 studies · 263 participants | Moderate Downgraded: imprecision |
Sulfasalazine compared to Corticosteroids for induction of remission or response in Crohn's disease
Population: patients with induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission (CDAI <150) Sulfasalazine vs Corticosteroids | RR 0.68 [0.51, 0.91] | 2 studies · 260 participants | Moderate Downgraded: imprecision |
Sulfasalazine compared to Sulfasalazine and corticosteroids for induction of remission or response in Crohn's disease
Population: patients with induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission Sulfasalazine vs Sulfasalazine and corticosteroids | RR 0.64 [0.47, 0.86] | 1 study · 110 participants | Moderate Downgraded: imprecision |
Controlled‐release mesalamine (1 ‐ 2 g/day) compared to Placebo for induction of remission or response in Crohn's disease
Population: patients with induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Decrease in CDAI >=50, HBI >=2 or improvement/remission (as defined by Tvede et al) Controlled‐release mesalamine (1 ‐ 2 g/day) vs Placebo | RR 1.07 [0.8, 1.42] | 3 studies · 342 participants | Low Downgraded: risk of bias, imprecision |
Induction of remission (CDAI <=150 + decrease of >=50 or as defined by Tvede et al) Controlled‐release mesalamine (1 ‐ 2 g/day) vs Placebo | RR 1.46 [0.89, 2.4] | 2 studies · 302 participants | Low Downgraded: risk of bias, imprecision |
Controlled‐release mesalamine (4 g/day) compared to Placebo for Induction of remission or response in Crohn's disease
Population: patients with Induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean change in baseline CDAI (Random effects model) Controlled‐release mesalamine (4 g/day) vs Placebo | no estimate extracted | 3 studies · 615 participants | Low Downgraded: risk of bias, inconsistency |
Mean change in baseline CDAI (Fixed effects model) Controlled‐release mesalamine (4 g/day) vs Placebo | no estimate extracted | 3 studies · 615 participants | Low Downgraded: risk of bias, inconsistency |
Azo‐bonded and delayed‐release mesalamine (2 ‐ 3.2 g/day) compared to Placebo for Induction of remission or response in Crohn's disease
Population: patients with Induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission or clinical improvement ‐ Olsalazine (2 g/day) Azo‐bonded and delayed‐release mesalamine (2 ‐ 3.2 g/day) vs Placebo | RR 0.36 [0.18, 0.71] | 1 study · 91 participants | Very low Downgraded: risk of bias, imprecision |
Induction of remission or clinical improvement ‐ Asacol (3.2 g/day) Azo‐bonded and delayed‐release mesalamine (2 ‐ 3.2 g/day) vs Placebo | RR 2.7 [1.06, 6.88] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Induction of remission (CDAI < 150 + decrease >=70) ‐ Asacol (3.2 g/day) Azo‐bonded and delayed‐release mesalamine (2 ‐ 3.2 g/day) vs Placebo | RR 2.03 [0.75, 5.45] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Delayed‐release mesalamine (3 ‐ 4.5 g/day) compared to Corticosteroids for Induction of remission or response in Crohn's disease
Population: patients with Induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission (CDAI < or =150 with or without decrease of at least 60 points) Delayed‐release mesalamine (3 ‐ 4.5 g/day) vs Corticosteroids | RR 1.04 [0.79, 1.36] | 3 studies · 178 participants | Moderate Downgraded: imprecision |
Induction of remission (CDAI < or =150 with or without decrease of at least 60 points) ‐ 3 g/day Delayed‐release mesalamine (3 ‐ 4.5 g/day) vs Corticosteroids | RR 0.95 [0.49, 1.85] | 1 study · 50 participants | Low Downgraded: imprecision |
Induction of remission (CDAI < or =150 with or without decrease of at least 60 points) ‐ 2.4 g/day Delayed‐release mesalamine (3 ‐ 4.5 g/day) vs Corticosteroids | RR 1 [0.61, 1.64] | 1 study · 50 participants | Moderate Downgraded: imprecision |
Induction of remission (CDAI < or =150 with or without decrease of at least 60 points) ‐ 4 g/day microgranules Delayed‐release mesalamine (3 ‐ 4.5 g/day) vs Corticosteroids | RR 1.26 [0.82, 1.92] | 1 study · 44 participants | Moderate Downgraded: imprecision |
Induction of remission (CDAI < or =150 with or without decrease of at least 60 points) ‐ 4.5 g/day Delayed‐release mesalamine (3 ‐ 4.5 g/day) vs Corticosteroids | RR 0.67 [0.3, 1.46] | 1 study · 34 participants | Low Downgraded: imprecision |
Mesalamine (4 ‐ 4.5 g/day) compared to Budesonide for Induction of remission or response in Crohn's disease
Population: patients with Induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission (CDAI < or = 150) ‐ Pentasa (4 g/day) Mesalamine (4 ‐ 4.5 g/day) vs Budesonide | RR 0.56 [0.4, 0.78] | 1 study · 182 participants | Low Downgraded: risk of bias, imprecision |
Induction of remission (CDAI < or = 150) ‐ Salofalk (4.5 g/day) Mesalamine (4 ‐ 4.5 g/day) vs Budesonide | RR 0.89 [0.76, 1.05] | 1 study · 307 participants | Moderate Downgraded: risk of bias, imprecision |
Mesalamine compared to Sulfasalazine (alone or in combination with corticosteroids) for Induction of remission or response in Crohn's disease
Population: patients with Induction of remission or response in Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction of remission (CDAI < 150) or clinical improvement ‐ Salofalk (1.5 g/day) Mesalamine vs Sulfasalazine (alone or | RR 1.18 [0.82, 1.7] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Induction of remission (CDAI < 150) or clinical improvement ‐ Salofalk (3.0 g/day) Mesalamine vs Sulfasalazine (alone or | RR 0.94 [0.75, 1.18] | 1 study · 50 participants | Low Downgraded: risk of bias, imprecision |