Hellers 1999.
Methods | Randomized, parallel‐group, double‐blind, placebo‐controlled, multicenter trial | |
Participants | Patients scheduled for surgical resection of ileocolonic CD (N = 130)
METHOD OF INDUCTION OF REMISSION: Surgical resection of diseased area EXCLUSION CRITERIA: 1) Previous ileal resection > 100 cm, 2) Infectious complication such as abscess or fistula, 3) Corticosteroids less than 30 days from surgery, 4) Any medication for treatment of CD (except budesonide) |
|
Interventions | Group 1: CIR budesonide (Entocort) 6 mg once daily for 52 weeks (n = 63) Group 2: Placebo for 52 weeks (n = 67) |
|
Outcomes | 1) Proportion of patients with disease in remission defined as CDAI < 150 at specific time points 2) Recurrence of disease defined by a score of 2 or higher on the Rutgeerts scale (Rutgeerts 1990) 3) CDAI score (note: baseline CDAI was taken 6 weeks after surgical resection to induce remission) 4) ACTH stimulation test (normal response defined as baseline plasma cortisol concentration > 150 nmol/L and a concentration of > 400 nmol/L or an increase of at least 200 nmol/L at 30 or 60 minutes). |
|
Notes | Additional unpublished data obtained from study sponsor | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No description provided |
Allocation concealment (selection bias) | Unclear risk | No description provided |
Blinding (performance bias and detection bias) All outcomes | Unclear risk | The study is described as double blind; however, no description is provided with regard to the mechanisms to ensure the blinding of participants and outcome assessors (endoscopists) |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Withdrawals similar across groups |
Selective reporting (reporting bias) | Low risk | All key outcomes were included |
Other bias | Low risk | No additional sources of bias were identified |