Steinhart A H, Hemphill D, Greenberg G R
Division of Gastroenterology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Am J Gastroenterol. 1994 Dec;89(12):2116-24.
The aim of this meta-analysis was to determine whether therapy with sulfasalazine or mesalazine is effective in the maintenance of clinical remission in patients with Crohn's disease.
Computerized searches of bibliographic databases were carried out to identify studies published up to October 1993 that were randomized controlled trials of sulfasalazine or mesalazine as single drug therapy in the prevention of symptomatic disease relapse in quiescent Crohn's disease. We extracted and statistically aggregated data from the trials, using a fixed effects model.
A total of 10 eligible trials involving a total of 1022 patients were identified. Therapy with sulfasalazine or mesalazine reduces the risk of clinical relapse of Crohn's disease 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 benefit 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].
Maintenance therapy with mesalazine or sulfasalazine reduces the risk of clinical disease relapse in Crohn's disease after 1 yr. This benefit is seen primarily in the more recent studies that have used mesalazine as the therapeutic agent.
本荟萃分析旨在确定柳氮磺胺吡啶或美沙拉嗪治疗对克罗恩病患者临床缓解的维持是否有效。
对书目数据库进行计算机检索，以识别截至1993年10月发表的研究，这些研究是关于柳氮磺胺吡啶或美沙拉嗪作为单一药物疗法预防静止期克罗恩病症状性疾病复发的随机对照试验。我们使用固定效应模型从试验中提取并统计汇总数据。
共识别出10项符合条件的试验，涉及1022名患者。柳氮磺胺吡啶或美沙拉嗪治疗可降低12个月后克罗恩病临床复发风险[相对危险度（RR）=0.77，95%置信区间（CI）0.64 - 0.92]。在3 - 6个月时益处不太明显[RR = 0.86，95% CI 0.67 - 1.09]。亚组分析表明美沙拉嗪有治疗益处，而柳氮磺胺吡啶没有[美沙拉嗪的RR = 0.63，95% CI 0.50 - 0.79；柳氮磺胺吡啶的RR = 1.08，95% CI 0.81 - 1.44]。
柳氮磺胺吡啶或美沙拉嗪维持治疗可降低1年后克罗恩病临床疾病复发风险。这种益处主要见于使用美沙拉嗪作为治疗药物的近期研究。
