Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease
Background/Aims Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods This was a retrospective analysis of CD patien...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Association for the Study of Intestinal Diseases
2021-07-01
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| Series: | Intestinal Research |
| Subjects: | |
| Online Access: | http://irjournal.org/upload/pdf/ir-2019-09172.pdf |
| _version_ | 1818456135309459456 |
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| author | Sanchit Sharma Arti Gupta Saurabh Kedia Samagra Agarwal Namrata Singh Sandeep Goyal Saransh Jain Vipin Gupta Pabitra Sahu Sudheer Kumar Vuyyuru Bhaskar Kante Raju Sharma Rajesh Panwar Peush Sahni Govind Makharia Vineet Ahuja |
| author_facet | Sanchit Sharma Arti Gupta Saurabh Kedia Samagra Agarwal Namrata Singh Sandeep Goyal Saransh Jain Vipin Gupta Pabitra Sahu Sudheer Kumar Vuyyuru Bhaskar Kante Raju Sharma Rajesh Panwar Peush Sahni Govind Makharia Vineet Ahuja |
| author_sort | Sanchit Sharma |
| collection | DOAJ |
| description | Background/Aims Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P=0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P=0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P=0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P=0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P=0.046) predicted response to EEN. Conclusions EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN. |
| first_indexed | 2024-12-14T22:21:51Z |
| format | Article |
| id | doaj.art-28c3424e40b447e98f215e9df0df9bc8 |
| institution | Directory Open Access Journal |
| issn | 1598-9100 2288-1956 |
| language | English |
| last_indexed | 2024-12-14T22:21:51Z |
| publishDate | 2021-07-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj.art-28c3424e40b447e98f215e9df0df9bc82022-12-21T22:45:28ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562021-07-0119329130010.5217/ir.2019.09172844Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s diseaseSanchit Sharma0Arti Gupta1Saurabh Kedia2Samagra Agarwal3Namrata Singh4Sandeep Goyal5Saransh Jain6Vipin Gupta7Pabitra Sahu8Sudheer Kumar Vuyyuru9Bhaskar Kante10Raju Sharma11Rajesh Panwar12Peush Sahni13Govind Makharia14Vineet Ahuja15 Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, IndiaBackground/Aims Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P=0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P=0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P=0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P=0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P=0.046) predicted response to EEN. Conclusions EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.http://irjournal.org/upload/pdf/ir-2019-09172.pdfexclusive enteral nutritioncrohn diseasecrohn’s disease activity indexinflammation |
| spellingShingle | Sanchit Sharma Arti Gupta Saurabh Kedia Samagra Agarwal Namrata Singh Sandeep Goyal Saransh Jain Vipin Gupta Pabitra Sahu Sudheer Kumar Vuyyuru Bhaskar Kante Raju Sharma Rajesh Panwar Peush Sahni Govind Makharia Vineet Ahuja Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease Intestinal Research exclusive enteral nutrition crohn disease crohn’s disease activity index inflammation |
| title | Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease |
| title_full | Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease |
| title_fullStr | Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease |
| title_full_unstemmed | Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease |
| title_short | Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease |
| title_sort | efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated crohn s disease |
| topic | exclusive enteral nutrition crohn disease crohn’s disease activity index inflammation |
| url | http://irjournal.org/upload/pdf/ir-2019-09172.pdf |
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