Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP
Moriczi, Melinda; Pujol-Muncunill, Gemma; Martín-Masot, Rafael; Jiménez Treviño, Santiago; Segarra Cantón, Oscar; Ochoa Sangrador, Carlos; Peña Quintana, Luis; González Santana, Daniel; Rodríguez Martínez, Alejandro; Rosell Camps, Antonio; Armas, Honorio; Barrio, Josefa; González de Caldas, Rafael; Rodríguez Salas, Mónica; Balmaseda Serrano, Elena; Donat Aliaga, Ester; Bodas Pinedo, Andrés; Vaquero Sosa, Esther; Vecino López, Raquel; Solar Boga, Alfonso; Moreno Alvarez, Ana; Sánchez Sánchez, César; Tolín Hernani, Mar; Gutiérrez Junquera, Carolina; Martinon Torres, Nazareth; Leis Trabazo, María Rosaura; Eizaguirre, Francisco Javier; García Peris, Mónica; Medina Benítez, Enrique; FERNANDEZ CAAMAÑO, BEATRIZ; Vegas Álvarez, Ana María; Crespo Valderrábano, Laura; Alonso Vicente, Carmen; Rubio Santiago, Javier; Galera-Martínez, Rafael; García-Romero, Ruth; Ros Arnal, Ignacio; Fernández Cebrián, Santiago Andrés; Lorenzo Garrido, Helena; Viada Bris, Javier Francisco; Velasco Rodríguez-Belvis, Marta; Bartolomé Porro, Juan Manuel; Blanco Rodríguez, Miriam; Barros García, Patricia; Botija, Gonzalo; Chicano Marín, Francisco José; La Orden Izquierdo, Enrique; Crehuá-Gaudiza, Elena; Navas-López, Víctor Manuel; Martín-de-Carpi, Javier
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DeCSinducción de remisión | estudios retrospectivos | enfermedad de Crohn | humanos | adolescente
MeSHRemission Induction | Humans | Crohn Disease | Adolescent | Retrospective Studies
Exclusive enteral nutrition (EEN) has been shown to be more effective than corticosteroids in achieving mucosal healing in children with Crohn s disease (CD) without the adverse effects of these drugs. The aims of this study were to determine the efficacy of EEN in terms of inducing clinical remission in children newly diagnosed with CD, to describe the predictive factors of response to EEN and the need for treatment with biological agents during the first 12 months of the disease. We conducted an observational retrospective multicentre study that included paediatric patients newly diagnosed with CD between 2014-2016 who underwent EEN. Two hundred and twenty-two patients (140 males) from 35 paediatric centres were included, with a mean age at diagnosis of 11.6 +/- 2.5 years. The median EEN duration was 8 weeks (IQR 6.6-8.5), and 184 of the patients (83%) achieved clinical remission (weighted paediatric Crohn's Disease activity index [wPCDAI] < 12.5). Faecal calprotectin (FC) levels (mug/g) decreased significantly after EEN (830 [IQR 500-1800] to 256 [IQR 120-585] p < 0.0001). Patients with wPCDAI </= 57.5, FC < 500 mug/g, CRP >15 mg/L and ileal involvement tended to respond better to EEN. EEN administered for 6-8 weeks is effective for inducing clinical remission. Due to the high response rate in our series, EEN should be used as the first-line therapy in luminal paediatric Crohn's disease regardless of the location of disease and disease activity.