Pediatr Gastroenterol Hepatol Nutr.  2019 Jan;22(1):72-79. 10.5223/pghn.2019.22.1.72.

Therapeutic Efficacy of Exclusive Enteral Nutrition with Specific Polymeric Diet in Pediatric Crohn's Disease

Affiliations
  • 1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. sykim2010@catholic.ac.kr

Abstract

PURPOSE
The efficacy of exclusive enteral nutrition (EEN) with a polymeric diet has not been confirmed in Korean pediatric patients with Crohn's disease (CD). This study aimed to compare the effectiveness of EEN with a specific polymeric diet (Encover®) and corticosteroids (CSs) for the induction of remission in Korean pediatric CD patients.
METHODS
We retrospectively compared data from 51 pediatric CD patients who underwent induction therapy with EEN (n=19) or CSs (n=32) at Severance Children's Hospital or Incheon St. Mary's Hospital in Korea. The primary endpoint of this study was the rate of clinical remission, defined as a Pediatric Crohn's Disease Activity Index (PCDAI) score < 10, after 8 weeks of induction treatment. Clinical, laboratory, and growth data at post-induction as well as their changes from baseline were also compared between groups.
RESULTS
After 8 weeks of induction therapy, clinical remission rates were 78.9% (15/19) and 65.6% (21/32) in the EEN and CS groups, respectively (p=0.313). No significant differences in PCDAI scores, laboratory variables, and growth parameters were noted between the two groups at post-induction. However, significant changes in albumin levels at post-induction were observed in the EEN group compared to the CS group (p=0.038).
CONCLUSION
Our results suggest that the effectiveness of EEN with a polymeric diet and CSs for induction therapy did not differ in Korean pediatric CD patients. EEN with a polymeric diet is a good first-line treatment option for the induction of remission in these patients.

Keyword

Enteral nutrition; Child; Crohn disease

MeSH Terms

Adrenal Cortex Hormones
Child
Crohn Disease*
Diet*
Enteral Nutrition*
Humans
Incheon
Korea
Polymers*
Remission Induction
Retrospective Studies
Adrenal Cortex Hormones
Polymers

Figure

  • Fig. 1 Flowchart of the study. EEN: exclusive enteral nutrition, PCDAI: Pediatric Crohn's Disease Activity Index, BMI: body mass index, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.


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