Effectiveness of Azathioprine in Maintaining Remission in Crohn's Disease: A Systematic Review

Marcella Correa da Silva Coelho, A. Botelho, P. Bruno, Monique Fernandino Dias, L. C. Bertges, E. Bertges, A. P. Ferreira
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Abstract

Objective: To use a systematized review to determine the effectiveness of azathioprine in maintaining remission in Crohn's disease. Method: This study is a systematic review of the literature based on a bibliographic survey having the US National Library of Medicine (PubMed) data collection as the investigative source. The survey was delimited between January 2018 and May 2018 with the following descriptive terms: "Azathioprine" AND "Crohn's disease". The inclusion criteria were as follows: original articles, experimental models in humans, published either in English or Portuguese. All studies that did not meet the inclusion criteria and those that did not address the scope of this research were excluded. The information was selected according to its relevance and separated into themes that would allow a more didactic interpretation of the results. Results: A total of forty studies were evaluated, of which 28 were excluded and 12 were made part of this review. Azathioprine has been effective in the sustained remission of the disease in most cases, especially in moderate to severe patients. A total of 378 patients were assessed. Conclusion: Azathioprine has shown to be an effective therapy, indicated for the maintenance of remission in refractory (corticosteroid-dependent) and recurrent cases of moderate to severe patients. The patient and the disease should be stratified and treated individually. Treatment of Crohn's disease is complex, and in many cases patients cannot return to their normal daily activities.
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硫唑嘌呤维持克罗恩病缓解的有效性:一项系统综述
目的:通过系统评价确定硫唑嘌呤维持克罗恩病缓解的有效性。方法:本研究是以美国国家医学图书馆(PubMed)数据收集为调查来源的书目调查为基础的文献系统综述。该调查定在2018年1月至2018年5月之间,描述性术语如下:“硫唑嘌呤”和“克罗恩病”。纳入标准如下:原创文章,人体实验模型,以英文或葡萄牙文发表。所有不符合纳入标准的研究以及不涉及本研究范围的研究均被排除。这些资料是根据其相关性选择的,并分成主题,以便对结果进行更具说教性的解释。结果:共评估了40项研究,其中28项被排除,12项被纳入本综述。在大多数情况下,硫唑嘌呤对疾病的持续缓解是有效的,特别是在中度至重度患者中。共有378名患者接受了评估。结论:硫唑嘌呤已被证明是一种有效的治疗方法,适用于难治性(皮质类固醇依赖)和中重度复发患者的缓解维持。病人和疾病应该分层和单独治疗。克罗恩病的治疗是复杂的,在许多情况下,患者无法恢复正常的日常活动。
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