Twelve‐week peptide‐based formula therapy may be effective in inducing remission of active Crohn disease among women who are pregnant or preparing for pregnancy

Abstract

Background: Conventional treatment for Crohn disease (CD) in pregnancy includes mesalamine, thiopurine, and anti-tumor necrosis factor (TNF)-α agents. However, women may abstain because of complications, nonresponse, or potential adverse outcomes. Peptide-based formula therapy, through oral or nasogastric feeding without other food intake, is an effective and safe therapy for active CD. Herein, We confirmed the effectiveness and safety of peptide-based formula therapy for active CD in pregnant women or those preparing for pregnancy.Method: Outcomes of peptide-based formula therapy to induce CD remission during pregnancy preparation and the conception period were evaluated retrospectively among 14 women. Efficacy was evaluated as the change in serum indices and inflammatory markers after 12-week treatment. Pregnancy outcomes were compared between 14 women treated with nutrition therapy and eight women using conventional CD drugs.Results: After 12 weeks, 85.7% (12 of 14) of patients treated with peptide-based formula achieved remission with a significant decrease in the CD activity index (P < .001) and high-sensitivity C-reactive protein level (P = .004). There were no effects of peptide-based formula therapy on pregnancy outcomes compared with conventional CD treatment (P > .05). Among the 12 patients who achieved CD remission with exclusive peptide-based formula therapy, 10 selected to continue total or partial peptide-based formula treatment to maintain CD remission throughout pregnancy. Conclusion:Peptide-based formula therapy, without other food intake, may provide a safe and effective alternative to conventional CD drugs to induce disease remission among women during conception and pregnancy.

Exclusive Enteral Nutrition in Adult Crohn’s Disease: an Overview of Clinical Practice and Perceived Barriers

“…Hence, this provides the rationale for a safe and effective alternative to conventional therapeutic strategies to induce clinical remission during pregnancy. 59 A recent retrospective analysis, conducted in 31 adults, described a significant improvement of clinical symptoms and biochemical parameters after a median duration of 4 weeks of EEN in adult patients with complicated CD. 60 It is noteworthy that among different phenotypes of CD, more than 80% patients had either stricturing or fistulizing disease.…”

Lipidomics reveals significant alterations associated with exclusive enteral nutrition treatment in adult patients with active Crohn’s disease

“…A meta-analysis including five randomized clinical trials that compared the effect of EEN with corticosteroids suggested that EEN was as efficacious as corticosteroids ( 8 ). Studies performed at our center have demonstrated that EEN is equally effective as steroids and biologics for inducing early clinical remission in adult patients with CD, particularly in complicated cases, such as those with intestinal fistulas, abdominal abscesses, inflammatory intestinal strictures, or treatment resistance ( 9 , 10 ). Specifically, EEN promotes mucosal healing (MH) and fistula closure and reduces abdominal abscess size.…”