Efficacy predictors of a 2-month exclusive enteral nutrition for inducing remission of active Crohn’s disease

Xue, Min; Zhang, Hanyun; Wang, Xiaoying; Xu, Dong; Jin, Dan; Li, Peiwei; Ye, Jun; Yu, Qiao; Chen, Yan

doi:10.1038/s41430-018-0198-7

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…We did not examine in detail the clinical, serological immune response, genetic or microbiome signatures that predict therapeutic response. Recently, Meng Xue et al con rmed that L4b involvement was negative and that high serum ALB was positively associated with clinical remission [22]. Casey M A et al also con rmed that bacterial taxa and functions are predictive of remission following exclusive enteral nutrition in pediatric CD patients [23].…”

Section: Discussionmentioning

confidence: 99%

Early predictors of induction of remission with exclusive enteral nutrition in pediatric Crohn's disease

Hu,

Lv,

Lou

et al. 2024

Preprint

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Background Exclusive enteral nutrition (EEN) is recommended as the first line therapy for mild to moderate pediatric Crohn's disease (CD) with inducing clinical remission and promoting mucosal healing. However, early factors that could predict the efficacy of EEN in inducing remission of CD is lack. Methods A total of 56 patients in the derivation cohort and 19 patients in the validation cohort were included in this study. Baseline clinical covariates were compared between the clinical remission group and the no clinical remission group and between the mucosal healing group and the no mucosal healing group. More than 100 laboratory covariates before EEN were analyzed with the Pediatric Crohn’s Disease Activity Index(PCDAI) and the Crohn’s Disease Endoscopic Index of Severity (CDEIS)at the end of the 8-week EEN. Predictive models were developed by forward stepwise (binary likelihood) logistic regression, and the probabilities of clinical remission and mucosal healing were calculated for selected baseline levels of covariates. Results The clinical remission diagnostic model performed well inboth the training cohort (AUC 0.93; p<0.05) and the validation cohort (AUC 0.72; p=0.19). Indirect bilirubin (IBIL)>4.95 μmol/L, CD3>76.78% and iron>9.025 mmol/L at baseline were associated with a reduced clinical remission rate. The mucosal healing diagnostic model also presented the optimal discrimination in both the derivation cohort (AUC 0.87; p<0.05) and the validation cohort (AUC 0.83; p=0.07). Factors determining a lower mucosal healing rate were human IL-10>4.35 μmol/L and RDW>14.55%. Conclusion IBIL, CD3 and iron are reliable predictors of the induction of clinical remission with EEN. Human IL-10 and RDW are early predictors of the induction of mucosal healing with EEN.

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Section: Discussionmentioning

confidence: 99%

Early predictors of induction of remission with exclusive enteral nutrition in pediatric Crohn's disease

Hu,

Lv,

Lou

et al. 2024

Preprint

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“… 29 Xue et al showed that the efficacy rate of EEN was 67.2% for CD patients in our center. 30 Adherence to medication is very important for the treatment of chronic diseases. 31 High adherence is associated with positive health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Medication Belief is Associated with Improved Adherence to Exclusive Enteral Nutrition in Patients with Crohn’s Disease

Sun

et al. 2021

PPA

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Background:The prevalence of Crohn's disease (CD) has been increasing rapidly in China, and the role of exclusive enteral nutrition (EEN) in the management of adult patients with active CD is evolving. Adherence is a key factor in the effective treatment of many chronic diseases. Aim: The aim of this study was to assess adherence to EEN of CD patients and to evaluate the relationship between medication belief and EEN adherence. Methods: A cross-sectional study was conducted, and demographic information, adherence to EEN, and beliefs about EEN were investigated. Medication belief was measured using the Beliefs about Medicines Questionnaire (BMQ)-Specific. Results: In all, 131 CD patients completed the questionnaire and were enrolled in this study. The high adherence rate was 73.3% (96 of 131 patients), and we found that medication belief, residency, medical insurance, and history of enteral nutrition therapy were factors affecting EEN adherence. More patients with a high BMQ score had high adherence to EEN (n = 54, 56.2%) compared to those with a low BMQ (n = 42, 43.8%). Moreover, price, taste, storage method, portability, and purchase convenience of EEN were not associated with adherence. Conclusion:The adherence to EEN among patients with CD is relatively high and is related to medication belief, residency and history of enteral nutrition. The type of enteral nutrition, taste, storage, and convenience of purchase were not associated with EEN adherence. Future study is warranted to explore the possible role of improving patients' beliefs in increasing adherence.

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EEN Yesterday and Today … CDED Today and Tomorrow

2020

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The treatment of Pediatric Crohn’s Disease (CD) requires attention both to achieve mucosal healing and to optimize growth, while also maintaining proper bone health. Exclusive Enteral Nutrition (EEN) is recommended as first-line treatment in luminal CD. The therapeutic mechanisms of EEN are being discovered by advances in the study of the gut microbiota. Although the total exclusion of a normal diet during the time of EEN continues to be of high importance, new modalities of dietary treatment suggest a successful future for the nutritional management of CD. In this sense, Crohn’s Disease Exclusion Diet (CDED) is a long-term strategy, it apparently acts on the mechanisms that influence the appearance of inflammation (reducing dietary exposure to products negatively affecting the microbiota), but does so using specific available whole foods to achieve this goal, increases the time of clinical remission and promotes healthy lifestyle habits. The development of CDED, which partly minimizes the problems of EEN, has enabled a turnaround in the treatment of pediatric CD. This review highlights the role of enteral nutrition in the treatment of Crohn’s disease with special emphasis on newer dietary modalities such as CDED.

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Efficacy predictors of a 2-month exclusive enteral nutrition for inducing remission of active Crohn’s disease

Cited by 3 publications

References 9 publications

Early predictors of induction of remission with exclusive enteral nutrition in pediatric Crohn's disease

Early predictors of induction of remission with exclusive enteral nutrition in pediatric Crohn's disease

Medication Belief is Associated with Improved Adherence to Exclusive Enteral Nutrition in Patients with Crohn’s Disease

EEN Yesterday and Today … CDED Today and Tomorrow

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