Exclusive enteral nutrition is an effective first line treatment for active pediatric Crohn's disease.
Dr Cameron and colleagues examined the effect of exclusive enteral nutrition on short- and long-term clinical outcome together with anthropometric measurements.
The research team reported that the retrospective case-note review in newly diagnosed Crohn's disease who completed 8 weeks of exclusive enteral nutrition.
Demographics, anthropometry, disease characteristics and inflammatory markers were collected at exclusive enteral nutrition initiation and at 1, 2, 6, 12 & 24 months post treatment initiation.
The doctors assessed that exclusive enteral nutrition response was determined by a patient global assessment.
The team evaluated 109 patients.
The research team reported that after 8 weeks exclusive enteral nutrition, 65 were in remission, 32 improved and 12 had no improvement.
By 4 weeks, mean weight/BMI z-score increased.
The team noted that between 4 and 8 weeks, baseline inflammatory markers all improved significantly by week 4 and ESR.
The research team observed that 63 out of 109 patients relapsed during follow-up.
|70% of patients who relapsed managed a 2nd course of exclusive enteral nutrition|
|Alimentary Pharmacology & Therapeutics|
The team found that 44 out of these 63 patients completed a second course of exclusive enteral nutrition with similar response rate, but lower weight gain.
The doctors assessed that height z-score did not change significantly over the 24 months.
Introduction of azathioprine within 6 months of diagnosis did not improve height outcomes at 24 months.
Weight and BMI z-score improved with Exclusive enteral nutrition and changes are sustained to 2 years, but height z-score did not.
Dr Cameron's team concluded, "About 70% of patients who relapsed during 2-year follow-up managed a 2nd course of exclusive enteral nutrition."
"The optimal therapeutic strategies for length of exclusive enteral nutrition course and to improve linear growth are awaited."