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The Swedish Crohn Trial: A Prematurely Terminated Randomized Controlled Trial of Thiopurines or Open Surgery for Primary Treatment of Ileocaecal Crohns Disease
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Department of Surgery, Höglandssjukhuset, Eksjö, Sweden.
Sahlgrens University Hospital, Sweden.
Northern Hospital Zeeland, Denmark.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
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2016 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 10, no 1, 50-54 p.Article in journal (Refereed) Published
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Text
Abstract [en]

Background and aims: The importance of efficient and safe treatment of Crohns disease is highlighted by its chronicity. Both medical and surgical treatments have shown good results in the symptomatic control of limited ileocaecal Crohns disease. The aim of this study was to compare medical treatment with surgical treatment of ileocaecal Crohns disease. Methods: Thirty-six patients from seven hospitals with primary ileocaecal Crohns disease were randomized to either medical or surgical treatment. The medical treatment was induction of remission with budesonide and thereafter maintenance treatment with azathioprine. The surgical treatment was open ileocaecal resection. Crohns disease activity index over time, expressed as area under the curve at 1, 3 and 5 years, was the primary endpoint. Subjective health measured with the 36-item Short Form Survey Instrument (SF36) and a visual analogue scale (VAS) were secondary endpoints. Results: There were no differences between the treatment groups in Crohns disease activity index over time. General health, measured as SF36 score, was higher in patients receiving surgical treatment than in those receiving medical treatment at 1 year, but there was no corresponding difference in VAS. Due to the slow inclusion rate and changes in clinical practice, the study was t = erminated prematurely. Conclusion: The study ended up being underpowered and should be interpreted with caution, but there was no clinically significant difference between the two treatment arms. Further studies are needed to address this important clinical question.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2016. Vol. 10, no 1, 50-54 p.
Keyword [en]
Surgery; clinical trials; quality of life; socio-economical and psychological endpoints
National Category
Clinical Medicine Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-126143DOI: 10.1093/ecco-jcc/jjv184ISI: 000370275900010PubMedID: 26507858OAI: oai:DiVA.org:liu-126143DiVA: diva2:912007
Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2017-11-30

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Sjödahl, RuneStröm, MagnusSöderholm, Johan DMyrelid, Pär

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Gerdin, LindaSjödahl, RuneStröm, MagnusSöderholm, Johan DMyrelid, Pär
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Surgery in LinköpingDivision of Neuro and Inflammation ScienceDepartment of Gastroentorology
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Journal of Crohn's & Colitis
Clinical MedicineGastroenterology and Hepatology

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