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dc.contributor.authorRamaswamy, P Kakkadasam
dc.contributor.authorMutsekwa, R
dc.contributor.authorLan, X
dc.contributor.authorChen, Y
dc.contributor.authorAngus, R
dc.contributor.authorMoattar, H
dc.contributor.authorEdwards, J
dc.contributor.authorShukla, D
dc.date.accessioned2020-04-21T01:18:37Z
dc.date.available2020-04-21T01:18:37Z
dc.date.issued2020
dc.identifier.issn1873-9946
dc.identifier.doi10.1093/ecco-jcc/jjz203.734
dc.identifier.urihttp://hdl.handle.net/10072/393299
dc.description.abstractBackground Exclusive Enteral nutrition (EEN) is not routinely used as induction therapy for adults with active Crohn’s disease (CD)due to limited adherence and palatability. The aim of this study was to assess the efficacy, tolerability and safety of EEN in adult patients with CD. Methods Retrospective analysis of data from patients with active CD who underwent induction therapy with EEN at a single centre from January 2018 to July 2019. All patients who completed at least 4 weeks of polymeric EEN diet were included in the final analysis. Primary Endpoint (PE) was steroid-free clinical remission (CDAI ≤150) or response (100 point decrease in CDAI) at the end of therapy. Secondary endpoint (SE) was achievement of biochemical remission (CRP <5 mg/l or Calprotectin <150 μg/g) at 8–10 weeks. Results Sixty-three patients were initiated on EEN, 50 patients who completed at least 4 weeks of EEN were included in the final analysis. Mean age was 42.4 years, 25 (50%) were females. Mean CDAI score at baseline was 260. Forty per cent of patients were on concurrent biologics and 66.6% were on concurrent immunomodulators. At the completion of EEN, 72% (36/50) of patients achieved PE (29 remission, 7 response). SE was achieved in 65.7% (23/35) of patients. EEN duration ≥ 6 weeks was more likely to achieve PE (75% vs. 55.5%, OR 2.7, P 0.01) and SE (71% vs. 25%, OR 7.3, P 0.001).EEN duration < 6 weeks and current smoking were less likely to achieve PE and SE. Patients with concomitant steroid use at baseline had PE of 77.7% (vs. 68.8% with EEN alone; OR 0.9, P 0.5), and SE of 66.6% (vs. 60.9% with EEN alone, OR 0.77, P 0.74). Disease location, behaviour, sex, disease duration, concurrent biologic use or concurrent immunomodulator use did not affect the PE or SE. Six patients reported adverse effects (3 nausea,2 diarrhoea,1 constipation). Male sex, ileal location, B2/B3 phenotype were more likely to complete a 6 week EEN course. Conclusion Polymeric EEN is well-tolerated, safe and efficacious in inducing remission in adults with active CD. EEN duration of ≥ 6 weeks has better outcomes. EEN alone or in combination with steroids induces remission in adult patients with active CD. Further controlled trials using polymeric EEN are necessary.
dc.languageEnglish
dc.publisherOxford University Press
dc.relation.ispartofconferencename15th Congress of ECCO
dc.relation.ispartofconferencetitleJournal of Crohn's and Colitis
dc.relation.ispartofdatefrom2020-02-12
dc.relation.ispartofdateto2020-02-15
dc.relation.ispartoflocationVienna, Austria
dc.relation.ispartofpagefromS505
dc.relation.ispartofpagetoS508
dc.relation.ispartofissueSupplement_1
dc.relation.ispartofvolume14
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode1103
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsGastroenterology & Hepatology
dc.titleExclusive enteral nutrition with a polymeric diet is efficacious in inducing remission in adults with active Crohn's disease
dc.typeConference output
dc.type.descriptionE3 - Conferences (Extract Paper)
dcterms.bibliographicCitationRamaswamy, PK; Mutsekwa, R; Lan, X; Chen, Y; Angus, R; Moattar, H; Edwards, J; Shukla, D, Exclusive enteral nutrition with a polymeric diet is efficacious in inducing remission in adults with active Crohn's disease, Journal of Crohn's and Colitis, 2020, 14, pp. S505-S508
dc.date.updated2020-04-21T01:15:38Z
gro.hasfulltextNo Full Text
gro.griffith.authorMutsekwa, Rumbidzai


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