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Evidence summaries

Corticosteroids for Maintaining Remission of Crohn's Disease

The use of corticosteroids does probably not significantly reduce the risk of relapse over a 24 month period of follow-up. Level of evidence: "C"

Three studies were included in a Cochrane review [Abstract] 1. The total number of subjects included in the analysis at the time points of 6, 12 and 24 months were 142, 131 and 95 for the corticosteroid group and 161, 138 and 87 for the control group. The dose of methylprednisolone or prednisone was 7.5 mg/d, 8 mg/d, and 0.25 mg/kg/d. The odds ratios for relapse on active treatment and the corresponding 95% confidence intervals were 0.71 (0.39 to 1.31), 0.82 (0.47 to 1.43) and 0.72 (0.38 to 1.35) at 6, 12 and 24 months. The NNTs were 24, 35, and 25, respectively.

Comment: The quality of evidence is downgraded by sparse data and heterogeneity of results in different patient groups (with trend to a benefit from corticosteroids).

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Primary/Secondary Keywords