Which Treatments Are Best for Crohn Disease?

Few randomized trials have directly compared the efficacy of pharmacotherapies for Crohn disease. In the absence of such data, investigators conducted a network meta-analysis comparing treatment efficacies using both direct and indirect evidence from available trials.

Of 39 randomized, controlled trials included, 24 provided efficacy data on induction of Crohn disease remission and 24 on maintenance.

For induction of remission, results were as follows:

• Azathioprine/6-mercaptopurine and methotrexate were not better than placebo.

• Infliximab, infliximab plus azathioprine, adalimumab, and vedolizumab were all better than placebo.

• Infliximab, infliximab plus azathioprine, and adalimumab were more effective than azathioprine/6-mercaptopurine.

• Adalimuma…