Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use

Abstract

Background and aimData on the effectiveness of polymeric exclusive enteral nutrition (EEN) in inducing biochemical remission in adults with active Crohn’s Disease (CD) is scarce. We aimed to assess the effectiveness of polymeric EEN in inducing biochemical remission in adults with active CD.MethodsSingle-centre retrospective study, from January 2018 to September 2022, of patients with active CD who received therapy with EEN, along with standard of care. Active CD was defined as C-Reactive Protein (CRP) ≥10 mg/L and/or faecal calprotectin (FC) ≥250 µg/g. Primary endpoint (PE) was biochemical remission at 8 weeks. Biochemical remission was defined as CRP <6 mg/L in patients with CRP ≥10 mg/L at baseline and/or FC <150 µg/g in patients with an FC ≥250 µg/g at baseline.Results61 patients were included, 32 (52.4%) female. PE was achieved in 35 (57.4%) patients; 20 (58.8%) with concurrent corticosteroid (CS) and 15 (55.6%) without CS use at baseline, p=1. 43.7% (7/16) of patients with ileal, 50% (4/8) with colonic and 64.9% (24/37) with ileocolonic (p=0.33) disease phenotype achieved PE. Fewer patients with baseline concurrent biological achieved PE (12/29 (41.38%) vs 23/32 (71.9%), p=0.021). On univariable analysis, the absence of biological therapy at baseline was a predictor for achieving PE (OR 3.6 (95% CI 1.23 to 10.6), p=0.019).ConclusionPolymeric EEN is effective in inducing biochemical remission in adults with active CD irrespective of disease location or concurrent CS use. Significantly fewer patients on concurrent biologics at baseline achieved biochemical remission.