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We agree with Danese et al 1 that prospective studies to evaluate the disease-modifying action of antitumour necrosis factor (anti-TNF) drugs are overdue. As a counterpoint to this informative review, we would like to highlight some additional evidence for the role of thiopurines as disease-modifying agents in Crohn’s disease. A cohort study by Magro et al 2 supports a role for thiopurines in delaying phenotype progression from an inflammatory (B1) to a stricturing/penetrating (B2/B3) disease (HR 0.15, 95% CI 0.11 to 0.19). A meta-analysis of 10 …
Contributors All authors contributed to the preparation of this letter.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.