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Updated: Jul 10, 2026

Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model
Published on: February 14, 2021
Exposing the weaknesses: a systematic review of azathioprine efficacy in ulcerative colitis
Yvette Leung1, Remo Panaccione, Brenda Hemmelgarn
1Division of Gastroenterology and Hepatology, University of Calgary Health Sciences Centre, G 087, 3330 Hospital Drive, NW, Calgary, AB, Canada.
Background:
Published trials evaluating the efficacy of 6-thioguanine anti-metabolites in the treatment of ulcerative colitis (UC) have yielded conflicting results. We performed a systematic review and meta-analysis to evaluate the clinical efficacy of 6-thioguanine anti-metabolites for the maintenance of clinical remission after standard induction with corticosteroids.
Methods:
A comprehensive search of online databases was conducted. Only randomized controlled trials with 6-thioguanine antimetabolites within a minimum duration of follow-up of 6 months were selected.
Results:
Five trials were included in the meta-analysis. The pooled relative risk estimate for "success of treatment" with azathioprine (AZA) compared to 5-aminosalicylic acid or placebo was 1.42 [95% confidence interval (CI): 0.93-2.17, p = 0.109]; when only trials of a higher quality were used, a pooled relative risk estimate of 2.05 (95% CI: 1.30-3.23, p = 0.002) was obtained.
Conclusions:
Pooled results demonstrated a modest efficacy of AZA for the treatment of ulcerative colitis. However, the use of AZA for the management of UC is not based on high-quality evidence.
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Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...