Exclusive enteral nutrition is effective and feasible as primary induction and re-induction therapy in Asian children with Crohn's disease

Chan, Kok Joo and Song, Zhi Liang and Chew, Kee Seang and Ng, Ruey Terng and Mohd Taib, Siti Hawa and Lee, Way Seah (2021) Exclusive enteral nutrition is effective and feasible as primary induction and re-induction therapy in Asian children with Crohn's disease. Journal of Paediatrics and Child Health, 57 (2). pp. 239-245. ISSN 1034-4810, DOI https://doi.org/10.1111/jpc.15184.

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Abstract

Aim We aimed to ascertain the efficacy and feasibility of exclusive enteral nutrition (EEN) as an induction and re-induction therapy in Asian children with Crohn's disease (CD). Methods All children diagnosed with CD between 1995 and 2019 were reviewed. Response to induction was compared between EEN and standard immunosuppression (IS) using Paediatric Crohn's Disease Activity Index, growth failure, perianal disease and extra-intestinal manifestations. Two study groups were analysed: (i) primary induction and (ii) re-induction for relapses. Results Twenty-nine children (mean age (+/- standard deviation) at diagnosis 9.4 +/- 8.5 years old, ileo-colonic 35%, non-stricturing 79%) were studied. At primary induction (group 1;n= 18), no difference was observed in remission rates (9/13 vs.5/5;P= 0.278), efficacy for improving growth failure (6/8 vs.0/1;P> 0.999), perianal disease (4/6 vs.0/2;P> 0.999) and extra-intestinal manifestations (2/2 vs.0/0;P> 0.999) with EEN or standard IS. Group 2 (n= 38 relapses), no difference was observed in remission rates (16/19 vs.15/19,P> 0.999), growth failure (0/7 vs.4/14;P =0.328), perianal disease (1/10 vs.7/7;P> 0.999) and extra-intestinal manifestations (0/0 vs.1/1;P> 0.999) with EEN or standard IS. Both treatment modalities were equally effective as re-induction in relapses in patients previously treated with EEN (P =0.191). Conclusion As compared to standard IS, EEN was equally effective in primary induction and re-induction for relapse in Asian children with CD and can be repeatedly used for recurrent relapses.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Acceptability; Asian children; Crohn's disease; Efficacy; Exclusive enteral nutrition
Subjects: R Medicine
R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine > Paediatrics Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 12 Apr 2022 23:53
Last Modified: 12 Apr 2022 23:53
URI: http://eprints.um.edu.my/id/eprint/28361

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