G46(P) Maintenance enteral nutrition post induction therapy in paediatric crohns disease: Abstract G46(P) Table 1

Abstract

IntroductionSeveral studies suggest that maintenance enteral nutrition (MEN) post induction in Crohns Disease (CD) may have a role in prolonging remission. This retrospective study compares growth outcomes and relapse rate in CD patients supplemented with MEN versus an unsupplemented group.MethodsData including anthropometry, treatment type and outcome were collected for 78 patients at diagnosis, start of MEN, at 3 months and at 1 year from 2012–14. Patients who received MEN (n = 42) post induction therapy were compared with those on normal diet (ND; n = 36).Clinical remission was determined using a physician global assessment and blood biochemistry. Relapse was defined as a change in medication due to symptoms. Data are presented as median values.ResultsAge at diagnosis was 13 years, 62/78 (79%) were male. All groups had similar rates of clinical remission post induction therapy. The length of MEN was 3 months. The energy content of MEN was 635kcals representing 33% of energy requirement. 32/42 (76%) MEN patients received EEN as induction therapy, 7/42 (17%) received PEN and 3/42 (7%) steroids.Abstract G46(P) Table 1Relapse rates, HAZ and BMIZ in MEN and ND groups from diagnosis to 1 yearDiagnosisStart of MEN3 months1 yearNo of patients relapsing at less than 6 monthsMEN (n = 42)HAZBMIZ- 0.34-1.63**- 0.23- 0.56- 0.26- 0.28- 0.31- 0.30**10/42* (24%)ND (n = 36)HAZBMIZ- 0.28- 0.63***- 0.32- 0.08- 0.360.16- 0.32- 0.20***19/36* (53%)*P = 0.009 **MEN p < 0.001; ***ND p = 0.0224% of MEN group relapsed within 6 months of diagnosis versus 53% ND (p = 0.009). Body mass index z score (BMIZ) significantly improved in both groups (MEN: p < 0.001; ND: p = 0.02). There were no differences in height-for-age z scores (HAZ).ConclusionCD patients treated with MEN who received EEN or PEN as induction therapy were less likely to relapse within 6 months of diagnosis. BMIZ improved towards normal in both groups. Prolonged nutritional support from diagnosis may extend length of remission.