Russell Richard K, Fagbemi Andrew, Benyacoub Jalil, Capobianco Maria E, Wells Laura E, Shergill-Bonner Rita, Sharma Preeti, Patel Minal
Department of Paediatric Gastroenterology, Clinical Staff Offices, Royal Hospital for Children and Young People, Edinburgh, UK.
Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Expert Rev Gastroenterol Hepatol. 2025 Apr-May;19(5):455-465. doi: 10.1080/17474124.2025.2488887. Epub 2025 Apr 10.
This systematic literature review (SLR) aims to compare the clinical, humanistic, and economic outcomes associated with specialized and standard nutritional formulas for the treatment of mild-to-moderate pediatric Crohn's disease.
Search strategies were applied across MEDLINE, Cochrane and Web of Science (January 2000-October 2023) and recent congress proceedings (January 2021-October 2023). PRISMA-P guidelines were followed. Quality assessment evaluated risk of bias.
Twenty-three unique studies met the inclusion criteria. Nineteen studies (754 patients) evaluated specialized formula, 10 assessed standard formula (246 patients). Mucosal healing (7 studies), induction (20 studies) and maintenance of remission (9 studies) were reported over various timeframes. High proportions of patients who received specialized formula achieved mucosal healing (63-89% 8 weeks; 25-74% 10 weeks), and remission (50-100% 8 weeks). Specialized formula sustained remission (34-62.5% 6 months and 24-87.5% 1 year). Results were not directly comparable with standard formula due to significant heterogeneity in study methodology, patient populations, and remission definition.
The evidence predominantly supports the benefits of specialized formula in inducing mucosal healing, remission, and sustaining positive outcomes across multiple timepoints. Direct comparison of nutritional interventions is required to further support the findings of this SLR. PROSPERO CRD42023472370.
本系统文献综述旨在比较用于治疗轻至中度儿童克罗恩病的特殊营养配方和标准营养配方在临床、人文和经济方面的效果。
检索策略应用于MEDLINE、Cochrane和科学网（2000年1月至2023年10月）以及近期会议论文集（2021年1月至2023年10月）。遵循PRISMA-P指南。质量评估评估偏倚风险。
23项独特研究符合纳入标准。19项研究（754例患者）评估了特殊配方，10项评估了标准配方（246例患者）。在不同时间段报告了黏膜愈合（7项研究）、诱导缓解（20项研究）和维持缓解（9项研究）情况。接受特殊配方的患者中，高比例患者实现了黏膜愈合（8周时为63 - 89%；10周时为25 - 74%）和缓解（8周时为50 - 100%）。特殊配方维持缓解（6个月时为34 - 62.5%，1年时为24 - 87.5%）。由于研究方法、患者群体和缓解定义存在显著异质性，结果无法与标准配方直接比较。
证据主要支持特殊配方在诱导黏膜愈合、缓解以及在多个时间点维持积极效果方面的益处。需要对营养干预措施进行直接比较，以进一步支持本系统文献综述的结果。PROSPERO CRD42023472370。
