The aim of this study was to evaluate the short- and long-term outcomes of exclusive enteral nutrition (EEN) versus corticosteroids (CS) as induction therapy, in a cohort of pediatric patients with Crohn’s disease (CD). A retrospective study of patients with CD has been conducted. Clinical characteristics, laboratory parameters, and pediatric Crohn’s disease activity index (PCDAI) were evaluated at diagnosis and at different follow-up points. Subjects were divided in EEN-induction group, receiving EEN, and CS-induction group, treated with oral CS. We evaluated 47 patients in the EEN-induction group and 21 patients in the CS-induction group. After 8 weeks from diagnosis, we detected a significant improvement in CRP (p = 0.001) and albumin (p = 0.05), in EEN-induction group compared with the CS-induction group. PCDAI was significantly lower in the EEN-induction group versus the CS-induction group after 8 weeks (p = 0.04) and 1 year (p = 0.03) of follow-up. After 2 years from diagnosis, the number of subjects needing immunomodulators (IMM, azathioprine or methotrexate) was significantly higher in the CS-induction group compared with the EEN-induction group (p = 0.02). Conclusion: EEN has the same effectiveness of CS therapy in induction of remission but seems to have a more pronounced effect on disease activity. In our cohort, the need to use IMM seems to be reduced in subjects initially treated with EEN.What is Known:• Exclusive enteral nutrition (EEN) has the same effectiveness of corticosteroids (CS) in the induction of remission in pediatric Crohn’s disease.• EEN offers numerous advantages over CS, in terms of improved nutrition and mucosal healing.What is New:• Induction of remission with EEN seems to have a more pronounced effect on disease activity compared to induction with CS.• In our cohort, induction of remission with EEN seems to reduce the need of therapy with immunomodulators at 2 years of follow-up.
Exclusive enteral nutrition effect on the clinical course of pediatric Crohn’s disease: a single center experience / Scarpato, E.; Strisciuglio, C.; Martinelli, M.; Russo, M.; Cenni, S.; Casertano, M.; Serra, M. R.; Staiano, A.; Miele, E.. - In: EUROPEAN JOURNAL OF PEDIATRICS. - ISSN 0340-6199. - 179:12(2020), pp. 1925-1934. [10.1007/s00431-020-03753-x]
Exclusive enteral nutrition effect on the clinical course of pediatric Crohn’s disease: a single center experience
Scarpato E.;Strisciuglio C.;Martinelli M.;Cenni S.;Serra M. R.;Staiano A.;Miele E.
2020
Abstract
The aim of this study was to evaluate the short- and long-term outcomes of exclusive enteral nutrition (EEN) versus corticosteroids (CS) as induction therapy, in a cohort of pediatric patients with Crohn’s disease (CD). A retrospective study of patients with CD has been conducted. Clinical characteristics, laboratory parameters, and pediatric Crohn’s disease activity index (PCDAI) were evaluated at diagnosis and at different follow-up points. Subjects were divided in EEN-induction group, receiving EEN, and CS-induction group, treated with oral CS. We evaluated 47 patients in the EEN-induction group and 21 patients in the CS-induction group. After 8 weeks from diagnosis, we detected a significant improvement in CRP (p = 0.001) and albumin (p = 0.05), in EEN-induction group compared with the CS-induction group. PCDAI was significantly lower in the EEN-induction group versus the CS-induction group after 8 weeks (p = 0.04) and 1 year (p = 0.03) of follow-up. After 2 years from diagnosis, the number of subjects needing immunomodulators (IMM, azathioprine or methotrexate) was significantly higher in the CS-induction group compared with the EEN-induction group (p = 0.02). Conclusion: EEN has the same effectiveness of CS therapy in induction of remission but seems to have a more pronounced effect on disease activity. In our cohort, the need to use IMM seems to be reduced in subjects initially treated with EEN.What is Known:• Exclusive enteral nutrition (EEN) has the same effectiveness of corticosteroids (CS) in the induction of remission in pediatric Crohn’s disease.• EEN offers numerous advantages over CS, in terms of improved nutrition and mucosal healing.What is New:• Induction of remission with EEN seems to have a more pronounced effect on disease activity compared to induction with CS.• In our cohort, induction of remission with EEN seems to reduce the need of therapy with immunomodulators at 2 years of follow-up.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
