Corticosteroids for Crohn's Disease

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Drug therapy for Crohn's disease has been largely empirical. Sulfasalazine (Azulfidine®) is widely used and recommended (1) in mild disease, the rationale being by analogy from its proven effect in ulcerative colitis. Azathioprine, found useful in some small controlled trials and not in others (2), was not significantly better than placebo in the National Cooperative Crohn's Disease Study (NCCDS) (3). A recent well-controlled trial in London found that withdrawal of azathioprine after the disease had been in remission 6 or more months precipitated flare-up (4). It is currently under study in a large cooperative European trial. The metabolic product of

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