{"id":6165,"date":"2020-08-07T09:02:03","date_gmt":"2020-08-07T08:02:03","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6165"},"modified":"2021-10-04T13:18:41","modified_gmt":"2021-10-04T12:18:41","slug":"randomized-trial-of-ciprofloxacin-doxycycline-and-hydroxychloroquine-versus-budesonide-in-active-crohns-disease-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/08\/07\/randomized-trial-of-ciprofloxacin-doxycycline-and-hydroxychloroquine-versus-budesonide-in-active-crohns-disease-2020\/","title":{"rendered":"Randomized Trial of Ciprofloxacin Doxycycline and Hydroxychloroquine Versus Budesonide in Active Crohn's Disease (2021)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nRandomised controlled trial<\/p>\n<p><strong>Author(s):<\/strong><br \/>\nRhodes J.M.; Subramanian S.; Martin K.; Probert C.; Flanagan P.K.; Horgan G.W.; Mansfield J.; Parkes M.; Hart A.; Dallal H.; Iqbal T.; *Butterworth J.; Culshaw K.<\/p>\n<p><strong>Citation:<\/strong><br \/>\nDigestive Diseases and Sciences; Aug 2021; vol. 66 (no. 8); p. 2700-2711<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nBackground: Increased mucosa-associated E. coli are present in Crohn's disease, but their role in pathogenesis is uncertain. Aim(s): To assess efficacy and safety of an antibiotic\/hydroxychloroquine combination effective against E. coli inside macrophages. Method(s): Adults with moderately active disease (CDAI &gt; 220-450 plus C reactive protein &gt;= 5 mg\/l and\/or fecal calprotectin &gt; 250 mug\/g) were randomized to receive (open-label) oral budesonide (Entocort CR 9 mg\/day 8 weeks, 6 mg\/day 2 weeks, 3 mg\/day 2 weeks) or oral ciprofloxacin 500 mg bd, doxycycline 100 mg bd, hydroxychloroquine 200 mg tds for 4 weeks, followed by doxycycline 100 mg bd and hydroxychloroquine 200 mg tds for 20 weeks. Primary endpoints were remission (CDAI &lt;= 150) at 10 weeks, remission maintained to 24 weeks, and remission maintained to 52 weeks. Patients not responding (CDAI fall by &gt; 70) by 10 weeks were invited to crossover onto the alternative therapy. Result(s): Fifty-nine patients were recruited across 8 sites. Including crossover, 39 patients received antibiotics\/hydroxychloroquine and 39 received budesonide. At 10 weeks, 24 weeks, and 52 weeks on initial therapy, only 2\/27, 2\/27, and 1\/27 were in remission on antibiotics\/hydroxychloroquine compared with 8\/32, 1\/32, and 1\/32 on budesonide (P = 0.092 at 10 weeks). Withdrawals by 10 weeks due to adverse events were seen in 15 receiving antibiotics\/hydroxychloroquine and 6 budesonide. Results including crossover were more promising with 9\/24 patients receiving antibiotics\/hydroxychloroquine per protocol in remission by 24 weeks. No correlation was seen between response to antibiotics\/hydroxychloroquine and ASCA\/OmpC antibody status or disease location. Conclusion(s): Overall results with this antibiotic\/hydroxychloroquine combination were unimpressive, but long-term remission is seen in some patients and justifies further study.<\/p>\n<p><strong>Altmetrics:<\/strong><\/p>\n<div class=\"altmetric-embed\" data-badge-details=\"right\" data-badge-type=\"medium-donut\" data-pmid=\"32681228\" data-hide-no-mentions=\"true\"><\/div>\n<p><script type='text\/javascript' src='https:\/\/d1bxh8uas1mnw7.cloudfront.net\/assets\/embed.js'><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Randomised controlled trial Author(s): Rhodes J.M.; Subramanian S.; Martin K.; Probert C.; Flanagan P.K.; Horgan G.W.; Mansfield J.; Parkes M.; Hart A.; Dallal H.; Iqbal T.; *Butterworth J.; Culshaw K. Citation: Digestive Diseases and Sciences; Aug 2021;<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2020\/08\/07\/randomized-trial-of-ciprofloxacin-doxycycline-and-hydroxychloroquine-versus-budesonide-in-active-crohns-disease-2020\/\">Read more <span class=\"screen-reader-text\">Randomized Trial of Ciprofloxacin Doxycycline and Hydroxychloroquine Versus Budesonide in Active Crohn's Disease (2021)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[979,962,221],"class_list":["post-6165","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-979","tag-crohns-disease","tag-gastroenterology"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6165","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=6165"}],"version-history":[{"count":4,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6165\/revisions"}],"predecessor-version":[{"id":6727,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6165\/revisions\/6727"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=6165"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=6165"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=6165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}