Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Exclusive Enteral Nutrition as Induction Therapy for Paediatric Crohn Disease – Efficacy, Outcomes and Predictors of Response over a Ten-Year Period

Version 1 : Received: 19 September 2024 / Approved: 19 September 2024 / Online: 19 September 2024 (12:37:16 CEST)

How to cite: Brown, S.; Wall, C. L.; Frampton, C.; Gearry, R. B.; Day, A. S. Exclusive Enteral Nutrition as Induction Therapy for Paediatric Crohn Disease – Efficacy, Outcomes and Predictors of Response over a Ten-Year Period. Preprints 2024, 2024091531. https://doi.org/10.20944/preprints202409.1531.v1 Brown, S.; Wall, C. L.; Frampton, C.; Gearry, R. B.; Day, A. S. Exclusive Enteral Nutrition as Induction Therapy for Paediatric Crohn Disease – Efficacy, Outcomes and Predictors of Response over a Ten-Year Period. Preprints 2024, 2024091531. https://doi.org/10.20944/preprints202409.1531.v1

Abstract

Background: Exclusive enteral nutrition (EEN) is the recommended first-line induction therapy for pediatric patients with active luminal Crohn’s disease (CD). The primary aim of this retrospective study was to ascertain the efficacy of EEN used as induction therapy for children with newly diagnosed CD resident in the South Island of NZ over a ten-year period (2010 – 2021). Secondary aims were to assess the clinical impact of EEN therapy on anthropometry, biochemistry, the progression to medical therapies over three time periods, and to identify positive predictors of response to EEN therapy. Methods: This retrospective clinical case review collected data from children diagnosed with CD at Christchurch Hospital, Christchurch, New Zealand, and prescribed EEN as induction therapy between the years January 1st, 2010 – December 31st, 2021. Descriptive statistics, Spearman’s correlation coefficient, multivariate logistic regression test and standard t-tests were used for analyses. Results: Data were collected for total of 161 children, 128 (80%) children were offered EEN as induction therapy and were included in this analysis. One hundred and twenty-one (94.5%) children successfully completed an eight-week course of EEN, and a decrease in PCDAI scores ≥ 15 points from baseline to the end of week 8 of EEN treatment was seen in 119 (98.3%). L1 and L4 disease location were positive predictors of response (p<0.05). One hundred and two (89.3%) children achieved disease remission defined as PCDAI <10 at the eight-week time-point. Conclusions: These children with newly diagnosed CD from the South Island of NZ achieved high rates of clinical remission using EEN as induction therapy. Moreover, these children also experienced significantly improved growth parameters and biochemical markers of disease consequent to their course of EEN.

Keywords

inflammatory bowel disease; Crohn's disease; paediatric; nutrition; exclusive enteral nutrition

Subject

Medicine and Pharmacology, Dietetics and Nutrition

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