title: Prevention of postoperative recurrence of Crohn's disease: Tripterygium wilfordii polyglycoside versus mesalazine.
abstract: OBJECTIVE
  To explore effectiveness and safety of polyglycosides of Tripterygium wilfordii (GTW) and mesalazine (5-aminosalicylic acid [5-ASA]) in preventing postoperative clinical and endoscopic recurrence of Crohn's disease.
  
  
  METHODS
  In this prospective, single-centre, single-blind study, postoperative Crohn's disease patients in remission were randomized to receive 1 mg/kg GTW daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Patients underwent physical examinations, ileocolonoscopies and biochemical analyses at baseline and weeks 13, 26 and 52, or when clinical recurrence was suspected. Outcome measures were proportion of patients showing clinical or endoscopic recurrence at week 52, and changes in Rutgeerts' and Crohn's Disease Activity Index (CDAI) scores.
  
  
  RESULTS
  Twenty-one patients were assigned to receive GTW and 18 to 5-ASA; two patients on GTW and one on 5-ASA were withdrawn. Clinical and endoscopic recurrences were less common in the GTW group (n = 4) versus the 5-ASA group (n = 9). There were improvements in Rutgeerts' scores for those taking GTW. Mean between-group CDAI scores were similar. No serious adverse events were reported.
  
  
  CONCLUSIONS
  These findings indicate that GTW appears to be an effective, well-tolerated prophylactic regimen, superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical Crohn's disease.
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University Medical School, Nanjing, China. jiananr@gmail.com
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.forename: Nansheng
authors.initials: N
authors.lastname: Liao
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.forename: Chaogang
authors.initials: C
authors.lastname: Fan
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.forename: Huajian
authors.initials: H
authors.lastname: Ren
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Zhao
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy* / Q000517:prevention & control / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006027:Glycosides / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use*; D008517:Phytotherapy; D011184:Postoperative Period; D012008:Recurrence; D029757:Tripterygium / Q000737:chemistry*
chemical_list: D006027:Glycosides; D019804:Mesalamine; D002097:C-Reactive Protein