Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review
Abstract Background Recent trials suggested that the Crohn’s disease (CD) exclusion diet (CDED) plus partial enteral nutrition (PEN) is a safe and effective strategy in remission induction of paediatric-onset CD. However, real-world evidence regarding the safety and efficacy of the CDED plus PEN app...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-023-02857-6 |
| _version_ | 1797789685412528128 |
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| author | María Clara Jijón Andrade Gemma Pujol Muncunill Ana Lozano Ruf Laura Álvarez Carnero Victor Vila Miravet Dolores García Arenas Natalia Egea Castillo Javier Martín de Carpi |
| author_facet | María Clara Jijón Andrade Gemma Pujol Muncunill Ana Lozano Ruf Laura Álvarez Carnero Victor Vila Miravet Dolores García Arenas Natalia Egea Castillo Javier Martín de Carpi |
| author_sort | María Clara Jijón Andrade |
| collection | DOAJ |
| description | Abstract Background Recent trials suggested that the Crohn’s disease (CD) exclusion diet (CDED) plus partial enteral nutrition (PEN) is a safe and effective strategy in remission induction of paediatric-onset CD. However, real-world evidence regarding the safety and efficacy of the CDED plus PEN approach is still lacking. The present case-series study reported our experience with the outcomes of CDED plus PEN in the paediatric-onset CD at disease onset and after the loss of response to biologics. Methods We conducted a retrospective chart review on children who were treated with CDED plus PEN through the period from July 2019 and December 2020. Clinical and laboratory data were retrieved and compared at baseline, 6, 12, and 24 weeks of treatment. The primary endpoint of the present study was the rate of clinical remission. Results The present study retrieved the data from 15 patients. Of them, nine patients were treatment naïve at the time of initiation of CDED plus PEN (group A) and the remaining patients relapsed on biologics before treatment. All patients in groups A and B exhibited clinical remission in week six, which was sustained until week 12. At the end of the follow-up, the clinical remission rate was 87% and 60% in groups A and B, respectively. No side effects were observed in both groups. In group A, the faecal calprotectin (FC) and albumin improved at week six, week 12, and week 24 (p < 0.05). The erythrocyte sedimentation rate (ESR) improved significantly at week 12 (p = 0.021) and week 24 (p = 0.027). At the same time, the haemoglobin and iron levels showed significant improvement only at week 24. For group B, only FC showed numerical reductions over time that did not reach the level of statistical significance. Conclusion Treatment with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in treatment-naive patients. However, the benefit of CDED plus PEN was less in patients who initiated the strategy after losing the response to biologics. |
| first_indexed | 2024-03-13T01:54:11Z |
| format | Article |
| id | doaj.art-21265cdd6f1b479d8c8bb3dfc3bbdb5d |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-03-13T01:54:11Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-21265cdd6f1b479d8c8bb3dfc3bbdb5d2023-07-02T11:17:39ZengBMCBMC Gastroenterology1471-230X2023-06-012311710.1186/s12876-023-02857-6Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart reviewMaría Clara Jijón Andrade0Gemma Pujol Muncunill1Ana Lozano Ruf2Laura Álvarez Carnero3Victor Vila Miravet4Dolores García Arenas5Natalia Egea Castillo6Javier Martín de Carpi7Unit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalUnit for the Comprehensive Care of Paediatric IBD, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Déu HospitalAbstract Background Recent trials suggested that the Crohn’s disease (CD) exclusion diet (CDED) plus partial enteral nutrition (PEN) is a safe and effective strategy in remission induction of paediatric-onset CD. However, real-world evidence regarding the safety and efficacy of the CDED plus PEN approach is still lacking. The present case-series study reported our experience with the outcomes of CDED plus PEN in the paediatric-onset CD at disease onset and after the loss of response to biologics. Methods We conducted a retrospective chart review on children who were treated with CDED plus PEN through the period from July 2019 and December 2020. Clinical and laboratory data were retrieved and compared at baseline, 6, 12, and 24 weeks of treatment. The primary endpoint of the present study was the rate of clinical remission. Results The present study retrieved the data from 15 patients. Of them, nine patients were treatment naïve at the time of initiation of CDED plus PEN (group A) and the remaining patients relapsed on biologics before treatment. All patients in groups A and B exhibited clinical remission in week six, which was sustained until week 12. At the end of the follow-up, the clinical remission rate was 87% and 60% in groups A and B, respectively. No side effects were observed in both groups. In group A, the faecal calprotectin (FC) and albumin improved at week six, week 12, and week 24 (p < 0.05). The erythrocyte sedimentation rate (ESR) improved significantly at week 12 (p = 0.021) and week 24 (p = 0.027). At the same time, the haemoglobin and iron levels showed significant improvement only at week 24. For group B, only FC showed numerical reductions over time that did not reach the level of statistical significance. Conclusion Treatment with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in treatment-naive patients. However, the benefit of CDED plus PEN was less in patients who initiated the strategy after losing the response to biologics.https://doi.org/10.1186/s12876-023-02857-6Crohn’s diseaseCrohn’s disease exclusion dietPartial enteral nutritionRemissionPaediatrics |
| spellingShingle | María Clara Jijón Andrade Gemma Pujol Muncunill Ana Lozano Ruf Laura Álvarez Carnero Victor Vila Miravet Dolores García Arenas Natalia Egea Castillo Javier Martín de Carpi Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review BMC Gastroenterology Crohn’s disease Crohn’s disease exclusion diet Partial enteral nutrition Remission Paediatrics |
| title | Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review |
| title_full | Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review |
| title_fullStr | Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review |
| title_full_unstemmed | Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review |
| title_short | Efficacy of Crohn’s disease exclusion diet in treatment -naïve children and children progressed on biological therapy: a retrospective chart review |
| title_sort | efficacy of crohn s disease exclusion diet in treatment naive children and children progressed on biological therapy a retrospective chart review |
| topic | Crohn’s disease Crohn’s disease exclusion diet Partial enteral nutrition Remission Paediatrics |
| url | https://doi.org/10.1186/s12876-023-02857-6 |
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