Despite potential adverse-events in a paediatric population, corticosteroids are used to induce remission in paediatric Crohn's disease.
Exclusive enteral nutrition also induces remission, but is infrequently used in the USA because corticosteroids are considered the superior therapy.
New data have become available since the publication of the most recent meta-analysis in 2007.
Dr Swaminath and colleagues from New York, USA investigated whether current literature supports the use of exclusive enteral nutrition versus corticosteroids in pediatric populations.
All studies with comparator arms of exclusive enteral nutrition and an exclusive corticosteroids, with remission clearly defined were identified by searching 8 online databases.
Of 2795 identified sources, 9 studies met the inclusion criteria.
|Intestinal healing was more likely among patients receiving exclusive enteral nutrition vs corticosteroids|
|Alimentary Pharmacology & Therapeutics|
The team noted that 8 of these had data that could be abstracted into a meta-analysis.
The research team found that exclusive enteral nutrition was as effective as corticosteroids in inducing remission in pediatric Crohn's disease.
The team observed no difference between exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's or relapsed.
Intestinal healing was significantly more likely among patients receiving exclusive enteral nutrition compared to corticosteroids.
The researchers noted no difference in the frequency of biomarker normalization including CRP, and fecal calprotectin.
Dr Swaminath's team concluded, "There is no difference in efficacy between exclusive enteral nutrition, and corticosteroids in induction of remission in Crohn's disease in a pediatric population."
"Exploratory analyses suggest that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing."