Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn's Disease: Results From the GROWTH CD Study.
| Title: | Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn's Disease: Results From the GROWTH CD Study. |
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| Authors: | Cohen-Dolev N; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Sladek M; Jagiellonian University Medical College, Krakow, Poland.; Hussey S; National Children's Research Centre, Crumlin; Department of Paediatrics, UCD and RCSI, Dublin, Ireland.; Turner D; Juliet Keidan Institute of Paediatric Gastroenterology, Hebrew University of Jerusalem, Jerusalem, Israel.; Veres G; First Department of Pediatrics, Semmelweis University, Budapest, Hungary.; Koletzko S; Ludwig Maximilians-Universität München, Dr von Hauner Children's Hospital, Munich, Germany.; Martin de Carpi J; Department of Gastroenterology, Hepatology and Pediatric Nutrition, Hospital Sant Joan de Deu, Barcelona, Spain.; Staiano A; Department of Translational Medical Science, University of Naples 'Federico II', Naples, Italy.; Shaoul R; Pediatric Gastroenterology Institute, Rambam Medical Center, Haifa, Israel.; Lionetti P; Paediatric Gastroenterology Unit, University of Florence-Meyer Hospital, Florence, Italy.; Amil Dias J; Pediatric Gastroenterology Unit, Centro Hospitalar de São João, Porto, Portugal.; Paerregaard A; Department of Paediatrics 460, Hvidovre University Hospital, Hvidovre, Denmark.; Nuti F; Pediatric Gastroenterology and Hepatology Unit, Sapienza University, Rome, Italy.; Pfeffer Gik T; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Ziv-Baran T; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Ben Avraham Shulman S; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Sarbagili Shabat C; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Sigall Boneh R; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Russell RK; Department of Paediatric Gastroenterology, Royal Hospital for Children, Glasgow, UK.; Levine A; Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon, Israel.; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. |
| Source: | Journal of Crohn's & colitis [J Crohns Colitis] 2018 Feb 28; Vol. 12 (3), pp. 306-312. |
| Publication Type: | Comparative Study; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101318676 Publication Model: Print Cited Medium: Internet ISSN: 1876-4479 (Electronic) Linking ISSN: 18739946 NLM ISO Abbreviation: J Crohns Colitis Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015- : Oxford : Oxford University Press; Original Publication: Amsterdam : Elsevier Science |
| MeSH Terms: | Body Height* ; Enteral Nutrition* ; Remission Induction*; Adrenal Cortex Hormones/*therapeutic use ; Crohn Disease/*therapy ; Rectal Fistula/*etiology; Abscess/etiology ; Biological Products/therapeutic use ; Constriction, Pathologic/etiology ; Crohn Disease/complications ; Crohn Disease/drug therapy ; Adolescent ; Child ; Female ; Humans ; Male ; Propensity Score ; Prospective Studies ; Recurrence ; Severity of Illness Index ; Treatment Outcome |
| Abstract: | Background: Exclusive enteral nutrition [EEN] and corticosteroids [CS] induce similar rates of remission in mild to moderate paediatric Crohn's disease [CD], but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long-term outcomes.; Methods: We prospectively followed newly diagnosed children aged < 17 years, with mild to moderate CD at baseline, for 2 years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks. Remission, relapses, complications [fibrostenotic disease, penetrating disease, and active perianal disease] and growth were recorded throughout the study. A propensity score analysis was performed.; Results: A total of 147 children [mean age 12.9 ± 3.2 years], treated by EEN [n = 60] or CS [n = 87] were included. New complications developed in 13.7% of CS [12/87] versus 11.6% of EEN [7/60], p = 0.29. Remission was achieved in 41/87 [47%] in CS and 38/60 [63%] EEN, p = 0.036. Median time to relapse did not differ [14.4 ± 1 months with CS, 16.05 ± 1.1 EEN, p = 0.28]. Mean height Z scores decreased from Week 0 to Week 78 with CS [-0.34 ± 1.1 to -0.51 ± 1.2, p = 0.01], but not with EEN [-0.32 ± 1.1 to -0.22 ± 0.9, p = 0.56]. In a propensity score analysis, EEN was superior to CS for inducing remission [p = 0.05] and trended to superiority for height Z score [p = 0.055].; Conclusions: Use of EEN was associated with higher remission rates and a trend toward better growth but with similar relapse and complication rates in new-onset mild to moderate paediatric CD.; (Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com) |
| Substance Nomenclature: | 0 (Adrenal Cortex Hormones); 0 (Biological Products) |
| Entry Date(s): | Date Created: 20171123 Date Completed: 20180914 Latest Revision: 20220321 |
| Update Code: | 20260130 |
| DOI: | 10.1093/ecco-jcc/jjx150 |
| PMID: | 29165666 |
| Database: | MEDLINE |
Comparative Study; Journal Article