P871 A modified Crohn’s disease exclusion diet in a multi-ethnic Asian setting

Abstract

Abstract Background Crohn’s disease exclusion diet (CDED) has been shown to be well-tolerated and effective in adults with active Crohn’s disease (CD). There is limited data on using CDED in Asian setting. We performed this study to evaluate the feasibility and tolerability of using CDED as a nutritional intervention in Asian adults with CD. Methods We performed a prospective single centre observational study using 12-weeks of CDED as a nutritional intervention in adults with CD. The original CDED was adapted to foods commonly eaten in Asia. Patients with active CD were offered CDED as monotherapy or as an adjunct treatment to drug therapy. Dietary counselling was done by a dietitian and all food was prepared by individual participants or their family members. Participants were seen at baseline, week 6 and week 12. Dietary compliance was monitored by physician using direct questioning and, modified Medication Adherence Rating Scale (MARS) questionnaire. In addition, dietitian monitored compliance using 24-hour dietary recall and 3-day food journal. We monitor the disease activity using Harvey Bradshaw Index (HBI), C-reactive protein (CRP) and faecal calprotectin (FC). (Figure 1) The primary endpoint was tolerance to CDED; secondary endpoints were compliance to CDED and biomarker normalization. Intolerance was defined as refusal to continue with CDED and withdrawal from study. This study was approved by Singhealth Institutional review Board. Informed consent was obtained from all participants. Results A total of 6 participants were recruited from November 2022 to May 2023. Most participants were young. Four patients were on biologics (1 infliximab, 1 adalimumab, 1 vedolizumab, 1 ustekinumab). Two patients had CDED as monotherapy. (Table 1). All participants were able to tolerate 12 weeks of CDED and were mostly compliant to CDED. (Table 1) 5 of 6 patients had downward trend of CRP at week 12 compared to baseline and 4 of 6 had Two patients who received CDED as monotherapy had biomarker normalization at week 12. All patients were continued on CDED for another 12 weeks (maintenance phase). Conclusion Dietary intervention using CDED is well-tolerated among Asian adults with CD. More data is required to confirm the efficacy of CDED, both as monotherapy and in combination with drug therapy.