Department of Nutrition, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
J Pediatr Gastroenterol Nutr. 2024 Jun;78(6):1279-1286. doi: 10.1002/jpn3.12215. Epub 2024 Apr 16.
The Crohn's disease exclusion diet (CDED) + partial enteral nutrition (PEN) is an emerging diet used to induce clinical remission in children with active Crohn's disease (CD). This study aims to determine the effectiveness of using the CDED+PEN to induce clinical remission in an Australian group of children with active CD using different PEN formulas and incorporating patient dietary requirements.
We retrospectively collected data from children (both newly diagnosed and with existing CD while on therapy) with active CD (Paediatric Crohn's Disease Activity Index [PCDAI] ≥10) and biochemical evidence of active disease (elevated C-reactive protein [CRP], erythrocyte sedimentation rate [ESR] or faecal calprotectin [FC]) who completed at least phase 1 (6 weeks) of the CDED+PEN to induce clinical remission. Data were collected at baseline, Week 6 and Week 12. The primary endpoint was clinical remission at Week 6 defined as PCDAI < 10.
Twenty-four children were included in phase 1 analysis (mean age 13.8 ± 3.2 years). Clinical remission at Week 6 was achieved in 17/24 (70.8%) patients. Mean PCDAI, CRP, ESR and FC decreased significantly after 6 weeks (p < 0.05). Formula type (cow's milk based, rice based, soy based) did not affect treatment efficacy. A greater than 50% decrease in FC was achieved in 14/21 (66.7%) patients who completed phase 1 and 12/14 (85.7%) patients who completed phase 2 of the CDED+PEN.
Formula modifications to the CDED+PEN do not impact the expected treatment efficacy in Australian children with active luminal CD.
克罗恩病排除饮食（CDED）+部分肠内营养（PEN）是一种新兴的饮食，用于诱导活动期克罗恩病（CD）患儿的临床缓解。本研究旨在确定在澳大利亚一组活动期 CD 患儿中使用 CDED+PEN 诱导临床缓解的效果，方法为使用不同的 PEN 配方并结合患者的饮食需求。
我们回顾性地收集了来自患有活动期 CD（小儿克罗恩病活动指数[PCDAI]≥10）和生化活动性疾病证据（CRP、ESR 或粪便钙卫蛋白[FC]升高）的儿童（新诊断和正在接受治疗的儿童）的数据，这些儿童至少完成了 CDED+PEN 的第 1 阶段（6 周）以诱导临床缓解。数据收集于基线、第 6 周和第 12 周。主要终点为第 6 周时的临床缓解定义为 PCDAI<10。
24 例患儿进入第 1 阶段分析（平均年龄 13.8±3.2 岁）。17/24（70.8%）例患儿在第 6 周达到临床缓解。第 6 周时 PCDAI、CRP、ESR 和 FC 显著降低（p<0.05）。配方类型（基于牛奶、基于大米、基于大豆）不影响治疗效果。完成第 1 阶段的 21 例患儿中，14 例（66.7%）患儿的 FC 降低 50%以上，完成第 2 阶段的 14 例患儿中，12 例（85.7%）患儿的 FC 降低 50%以上。
对 CDED+PEN 的配方进行修改不会影响澳大利亚活动期腔型 CD 患儿的预期治疗效果。
