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  • Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use

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Small bowel and nutrition
Original research
Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
  1. Hellen Kuo1,
  2. Katrina Tognolini2,
  3. Rumbidzai Mutsekwa3,
  4. Dheeraj Shukla1,
  5. Laura Willmann1,
  6. Hadi Moattar1,
  7. Alexander Dorrington1,
  8. Naveed Ishaq1,
  9. Maneesha Bhullar1,
  10. John Edwards1,
  11. Waled Mohsen1,
  12. Pradeep Kakkadasam Ramaswamy1
  1. 1 Digestive Health, Gold Coast University Hospital, Southport, Queensland, Australia
  2. 2 Department of Nutrition and Food Services, Gold Coast University Hospital, Southport, Queensland, Australia
  3. 3 Gastroenterology and Nutrition Departments, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
  1. Correspondence to Dr Hellen Kuo; hellen.kuo{at}health.qld.gov.au

Abstract

Background and aim Data on the effectiveness of polymeric exclusive enteral nutrition (EEN) in inducing biochemical remission in adults with active Crohn’s Disease (CD) is scarce. We aimed to assess the effectiveness of polymeric EEN in inducing biochemical remission in adults with active CD.

Methods Single-centre retrospective study, from January 2018 to September 2022, of patients with active CD who received therapy with EEN, along with standard of care. Active CD was defined as C-Reactive Protein (CRP) ≥10 mg/L and/or faecal calprotectin (FC) ≥250 µg/g. Primary endpoint (PE) was biochemical remission at 8 weeks. Biochemical remission was defined as CRP <6 mg/L in patients with CRP ≥10 mg/L at baseline and/or FC <150 µg/g in patients with an FC ≥250 µg/g at baseline.

Results 61 patients were included, 32 (52.4%) female. PE was achieved in 35 (57.4%) patients; 20 (58.8%) with concurrent corticosteroid (CS) and 15 (55.6%) without CS use at baseline, p=1. 43.7% (7/16) of patients with ileal, 50% (4/8) with colonic and 64.9% (24/37) with ileocolonic (p=0.33) disease phenotype achieved PE. Fewer patients with baseline concurrent biological achieved PE (12/29 (41.38%) vs 23/32 (71.9%), p=0.021). On univariable analysis, the absence of biological therapy at baseline was a predictor for achieving PE (OR 3.6 (95% CI 1.23 to 10.6), p=0.019).

Conclusion Polymeric EEN is effective in inducing biochemical remission in adults with active CD irrespective of disease location or concurrent CS use. Significantly fewer patients on concurrent biologics at baseline achieved biochemical remission.

  • ENTERAL NUTRITION
  • CROHN'S COLITIS
  • INFLAMMATORY BOWEL DISEASE
  • CROHN'S DISEASE

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/flgastro-2024-102749

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Presented at This paper was presented as an abstract at the 8th Congress of ECCO Copenhagen, Denmark, 1 March 2023–4 March 2023 and published in the Journal of Crohn's and Colitis.31

    • Contributors HK and KT contributed equally to this paper as first authors. HK submitted the study. HK, KT, DS, RM, MB, NI, AD, HM and LW contributed to the planning, acquisition and interpretation of data. JE and WM contributed to critical review for important intellectual content. PKR approved the final version to be published and is the guarantor.

    • Funding There has been no specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.