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Infliximab, azathioprine, or combination therapy for Crohn's disease.

N Engl J Med. 2010 Sep 9;363(11):1086-8


To the Editor: The Study of Biologic and Immunomodulator Naive Patients in Crohn's Disease (SONIC) ( number, NCT00094458) reported on by Colombel et al. (April 15 issue)(1) is considered a landmark trial of combination immunosuppressive therapy in Crohn's disease. Several points deserve critical comment. A surprising 41% of the infliximab group did not have mucosal lesions at baseline (Table 2 of the article); this suggests irritable bowel syndrome. Since induction therapy was only administered in the infliximab groups, azathioprine was not given a fair trial - it requires up to 6 months to act. Seven patients have to be treated . . .

PMID: 20825325 [PubMed - in process]

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