Tripterygium wilfordii hook F as maintenance treatment for Crohn's disease

Background: The traditional Chinese medicine, Tripterygium wilfordii Hook F (TwHF) is widely used to treat Crohn's disease (CD) in China. Methods: The authors compared different doses of TwHF with mesalazine in 198 patients with CD over a 52-week period. Subjects were randomized to receive mesalazine (3 g/d), low-dose TwHF (1.5 mg.kg-1.d-1), or high-dose TwHF (2.0 mg.kg-1.d21). Results: A total of 137 patients completed the study. At week 52, a significant lower proportion of patients in the high-dose TwHF group (7/71) had clinical recurrence compared with patients in the low-dose TwHF (15/68, P = 0.047) or mesalazine group (17/59, P = 0.006), whereas the difference between the lowdose TwHF group and the mesalazine group was not significant (P = 0.503). Patients receiving mesalazine experienced less adverse events than those receiving high-dose TwHF (P = 0.029) and those receiving low-dose TwHF (P = 0.048), but no significant difference was found about drug adverse events resulted withdrawal in the 3 groups (P < 0.05). In addition, compared with low-dose TwHF and mesalazine, the authors also detected significant superiority of highdose TwHF arm in the decrease of CDAI and SESCD (P < 0.05). Conclusion: A 2.0 mg/kg daily TwHF was well tolerated and prolonged remission in patients with CD.