Longer-Term Outcomes of Nutritional Management of Crohns Disease in Children
Digestive Diseases and Sciences, 06/29/2012
Lambert B et al. – Exclusive enteral nutrition (EEN) lead to multiple benefits beyond the initial period of inducing remission for these children, with positive outcomes over 2 years from diagnosis. Of particular clinical relevance to growing children was the reduced exposure to corticosteroids.Methods
- Children treated with EEN as initial therapy for newly diagnosed CD over a 5-year period were identified. Details of disease activity, growth, and drug requirements over the period of follow-up were noted.
- Outcomes in children managed with EEN were compared to a group of children initially treated with corticosteroids.
- Over this time period, 31 children were treated with EEN and 26 with corticosteroids.
- Twenty-six (84 %) of the 31 children treated with EEN entered remission.
- Children treated with EEN exhibited lower pediatric Crohn’s disease activity index (PCDAI) scores at 6 months (p = 0.02) and received lower cumulative doses of steroids over the study period (p < 0.0001) than the group treated with corticosteroids.
- Height increments over 24 months were greater in the EEN group (p = 0.01).
- Although the median times to relapse were the same, the EEN group had a lower incidence of relapse in each time interval and survival curve analysis showed lower risk of relapse (p = 0.008).