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

Abstract

Trusted evidence. Informed decisions. Better health.

Meta-analysis of the human gut microbiome uncovers shared and distinct microbial signatures between diseases

“…Most of the drugs designed to treat AD patients, such as lecanemab, donanemab, and remternetug, are focused on removing plaque ( 61 ). In contrast, many drugs that target IBD are immunosuppressants, such as azathioprine, mercaptopurine (6-MP), and methotrexate ( 62 ). While drugs used to treat IBD and AD are known to have very different functional roles, it is interesting to see how the microbial gene profiles between these two disease populations have discordance in the same metabolic pathways ( Fig.…”

Meta-analysis of the human gut microbiome uncovers shared and distinct microbial signatures between diseases

“…Most of the drugs designed to treat AD patients, such as lecanemab, donanemab, and remternetug, are focused on removing plaque ( 61 ). In contrast, many drugs that target IBD are immunosuppressants, such as azathioprine, mercaptopurine (6-MP), and methotrexate ( 62 ). While drugs used to treat IBD and AD are known to have very different functional roles, it is interesting to see how the microbial gene profiles between these two disease populations have discordance in the same metabolic pathways ( Fig.…”

Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

“…Similarly, in the CLASSIC-I trial, 36% of the patients who were naïve to anti-TNFα therapy achieved remission at 4 weeks following adalimumab administration compared with 12% in the placebo group ( P =0.001) [ 106 ]. Although thiopurines have been used to maintain the remission of steroid-dependent CD, recent clinical trials have suggested that AZA may be inferior to infliximab [ 107 ]. For instance, in the SONIC trial, combination therapy with AZA and infliximab exhibited superiority over AZA or infliximab monotherapy for achieving clinical remission (56.8% vs. 30% and 44.4%, P <0.001 compared with AZA alone and P =0.02 compared with infliximab alone) [ 108 ].…”

Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review

“…Induction of clinical remission in Crohn’s disease: In Chande et al[23], AZA and 6-MP showed no advantage over placebo [risk ratio (RR): 1.23; 95% confidence interval (CI): 0.97-1.55], MTX (RR: 1.13; 95%CI: 0.85-1.49) or 5-ASA (RR: 1.24; 95%CI: 0.80-1.91).…”

“…Induction of clinical response in Crohn’s disease: Induction of clinical response was evaluated in CD for AZA and 6-MP; neither demonstrated any advantage over placebo (RR: 1.26; 95%CI: 0.98-1.62)[23].…”

“…Mucosal healing: For mucosal healing induction in UC, one meta-analysis showed a favorable mucosal healing rate with tacrolimus versus placebo (RR: 0.59; 95%CI: 0.46-0.74) in a 12-wk horizon analysis[26]. When compared to IFX in CD, AZA was not favorable for induction of mucosal healing during a follow-up period of 26 wk[23]. The results of the retrieved meta-analyses, as well as their assessed quality, are presented according to primary outcome in Tables 1 2 3 4 5 6 and 7.…”

Meta-analysis of the human gut microbiome uncovers shared and distinct microbial signatures between diseases

“…Most of the drugs designed to treat AD patients, such as lecanemab, donanemab, and remternetug, are focused on removing plaque ( 61 ). In contrast, many drugs that target IBD are immunosuppressants, such as azathioprine, mercaptopurine (6-MP), and methotrexate ( 62 ). While drugs used to treat IBD and AD are known to have very different functional roles, it is interesting to see how the microbial gene profiles between these two disease populations have discordance in the same metabolic pathways ( Fig.…”

Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

“…Similarly, in the CLASSIC-I trial, 36% of the patients who were naïve to anti-TNFα therapy achieved remission at 4 weeks following adalimumab administration compared with 12% in the placebo group ( P =0.001) [ 106 ]. Although thiopurines have been used to maintain the remission of steroid-dependent CD, recent clinical trials have suggested that AZA may be inferior to infliximab [ 107 ]. For instance, in the SONIC trial, combination therapy with AZA and infliximab exhibited superiority over AZA or infliximab monotherapy for achieving clinical remission (56.8% vs. 30% and 44.4%, P <0.001 compared with AZA alone and P =0.02 compared with infliximab alone) [ 108 ].…”

Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review

“…Induction of clinical remission in Crohn’s disease: In Chande et al[23], AZA and 6-MP showed no advantage over placebo [risk ratio (RR): 1.23; 95% confidence interval (CI): 0.97-1.55], MTX (RR: 1.13; 95%CI: 0.85-1.49) or 5-ASA (RR: 1.24; 95%CI: 0.80-1.91).…”

“…Induction of clinical response in Crohn’s disease: Induction of clinical response was evaluated in CD for AZA and 6-MP; neither demonstrated any advantage over placebo (RR: 1.26; 95%CI: 0.98-1.62)[23].…”

“…Mucosal healing: For mucosal healing induction in UC, one meta-analysis showed a favorable mucosal healing rate with tacrolimus versus placebo (RR: 0.59; 95%CI: 0.46-0.74) in a 12-wk horizon analysis[26]. When compared to IFX in CD, AZA was not favorable for induction of mucosal healing during a follow-up period of 26 wk[23]. The results of the retrieved meta-analyses, as well as their assessed quality, are presented according to primary outcome in Tables 1 2 3 4 5 6 and 7.…”

Meta-analysis of the human gut microbiome uncovers shared and distinct microbial signatures between diseases

“…Most of the drugs designed to treat AD patients, such as lecanemab, donanemab, and remternetug, are focused on removing plaque ( 61 ). In contrast, many drugs that target IBD are immunosuppressants, such as azathioprine, mercaptopurine (6-MP), and methotrexate ( 62 ). While drugs used to treat IBD and AD are known to have very different functional roles, it is interesting to see how the microbial gene profiles between these two disease populations have discordance in the same metabolic pathways ( Fig.…”

Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

“…Similarly, in the CLASSIC-I trial, 36% of the patients who were naïve to anti-TNFα therapy achieved remission at 4 weeks following adalimumab administration compared with 12% in the placebo group ( P =0.001) [ 106 ]. Although thiopurines have been used to maintain the remission of steroid-dependent CD, recent clinical trials have suggested that AZA may be inferior to infliximab [ 107 ]. For instance, in the SONIC trial, combination therapy with AZA and infliximab exhibited superiority over AZA or infliximab monotherapy for achieving clinical remission (56.8% vs. 30% and 44.4%, P <0.001 compared with AZA alone and P =0.02 compared with infliximab alone) [ 108 ].…”

Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review

“…Induction of clinical remission in Crohn’s disease: In Chande et al[23], AZA and 6-MP showed no advantage over placebo [risk ratio (RR): 1.23; 95% confidence interval (CI): 0.97-1.55], MTX (RR: 1.13; 95%CI: 0.85-1.49) or 5-ASA (RR: 1.24; 95%CI: 0.80-1.91).…”

“…Induction of clinical response in Crohn’s disease: Induction of clinical response was evaluated in CD for AZA and 6-MP; neither demonstrated any advantage over placebo (RR: 1.26; 95%CI: 0.98-1.62)[23].…”

“…Mucosal healing: For mucosal healing induction in UC, one meta-analysis showed a favorable mucosal healing rate with tacrolimus versus placebo (RR: 0.59; 95%CI: 0.46-0.74) in a 12-wk horizon analysis[26]. When compared to IFX in CD, AZA was not favorable for induction of mucosal healing during a follow-up period of 26 wk[23]. The results of the retrieved meta-analyses, as well as their assessed quality, are presented according to primary outcome in Tables 1 2 3 4 5 6 and 7.…”