Recommendation ID
CG152/1
Question
Azathioprine:- For patients with intestinal Crohn's disease, does the addition of azathioprine to glucocorticosteroid treatment at diagnosis improve the long-term outcome compared with glucocorticosteroid treatment alone?
Any explanatory notes
(if applicable)
Why this is important:- Crohn's disease runs a relapsing and remitting course, with a significant inflammatory component during its early stages, and increasing degrees of fibrotic, stenosing or perforating disease later. Intervention during the inflammatory stage may affect disease progression while avoiding the side effects of glucocorticosteroid treatment – the current mainstay of treatment for exacerbations. Adults and children with a first presentation of intestinal Crohn's disease would be recruited once in remission and randomised to receive azathioprine or placebo for preventing relapse after an initial treatment with a glucocorticosteroid. Co-primary end points would be quality of life measures and maintaining glucocorticosteroid-free remission measured by the Crohn's Disease Activity Index (CDAI). Secondary end points would be mucosal healing at endoscopy, hospitalisation, side effects and surgery. Appropriate healthcare costs would also need to be assessed to inform a cost-effectiveness model. Follow-up should be at least 2 years, and ideally 5 years.

Source guidance details

Comes from guidance
Crohn's disease: management
Number
CG152
Date issued
October 2012

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 25/10/2012