SULFASALAZINE AND MESALAZINE FOR THE MAINTENANCE THERAPY OF CROHNS-DISEASE - A METAANALYSIS

Objective: The aim of this meta-analysis was to determine whether ther apy with sulfasalazine or mesalazine is effective in the maintenance o f clinical remission in patients with Crohn's disease. Methods: Comput erized searches of bibliographic databases were carried out to identif y studies published up to October 1993 that were randomized controlled trials of sulfasalazine or mesalazine as single drug therapy in the p revention of symptomatic disease relapse in quiescent Crohn's disease. We extracted and statistically aggregated data from the trials, using a fixed effects model. Results: A total of 10 eligible trials involvi ng a total of 1022 patients were identified. Therapy with sulfasalazin e or mesalazine reduces the risk of clinical relapse of Crohn's diseas e after 12 months [relative risk (RR) = 0.77, 95% confidence interval (CI) 0.64-0.92]. The benefit is less apparent at 3-6 months [RR = 0.86 , 95% CI 0.67-1.09]. Subgroup analysis indicated that therapeutic bene fit exists for mesalazine but not for sulfasalazine [RR for mesalazine 0.63, 95% CI 0.50-0.79; RR for sulfasalazine = 1.08, 95% CI 0.81-1.44 ]. Conclusions: Maintenance therapy with mesalazine or sulfasalazine r educes the risk of clinical disease relapse in Crohn's disease after 1 yr. This benefit is seen primarily in the more recent studies that ha ve used mesalazine as the therapeutic agent.