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Summary Introduction : Azathioprine is effective for maintenance of remission in Crohn's disease, however, duration of efficacy and the dose response relationship has not been fully evaluated. Aims : To investigate whether patients kept in remission by azathioprine treatment for >2 years benefit from further treatment, and to explore dose–response relationship. Patients and methods : In an open 12‐month trial, patients with inactive Crohn's disease after >2 years (median 37 months) of azathioprine treatment were randomized to azathioprine withdrawal or continued treatment. Primary end point was relapse defined as: (i) Crohn's disease activity index rise ≥ 75, and Crohn's disease activity index >150 or (ii) disease activity requiring intervention. Results : Of 29 patients, 28 completed the observation period or relapsed. Eleven of 13 patients (85%) continuing azathioprine remained in remission compared with seven of 15 (47%) observed without azathioprine (P = 0.043). In patients who had been treated with azathioprine >1.60 mg/kg/day the difference was even more pronounced, eight of nine (89%) vs. four of 12 (33%) respectively (P = 0.017). Conclusions : Patients with Crohn's disease in remission after >2 years of continuous azathioprine treatment will benefit from further continued treatment. Further controlled studies with azathioprine doses <2.0 mg/kg/day are needed.

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In most development projects, descriptions and prototypes are developed by system designers on their own utilizing users as suppliers of information on the use domain. In contrast, we are proposing a cooperative prototyping approach where users are involved actively and creatively in design and evaluation of early developed prototypes. This paper will present a detailed analysis of an example of application of the approach-design of computer support for casework in a technical department of a local government, where urban planning and environmental control of companies are central work tasks. The analysis starts out from the mutual object of design: the work processes of the prospective users. We look at design as a learning process and analyze various situations where openings for learning occur in the prototyping activity. These situations seem to fall into three categories: the first is situations where the future work situation is simulated and the conditions of the future work activity investigated, in particular the role of the computer application. The second is where the prototype is used as a basis for discussion and articulation of problems with the current work practice, and goals of the future one. The third kind of situations are situations where the design situation as such becomes the focus. Based on the example and earlier results we discuss benefits, problems and prospects of the approach. In particular we discuss the tension between needs for careful preparation of prototyping sessions and establishing good conditions for user and designer creativity. The message with this respect is that users and designers should learn from breakdowns and focus shifts in the prototyping sessions rather than trying to avoid them.