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Response pattern recognition in paediatric Crohn's disease patients treated with enteral nutrition
N Kjaersgaard Nielsen1, V Wewer, L Skafte
1Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark.
Insights
Enteral nutrition (EN) effectively treats paediatric Crohn
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Nutritional Therapy
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease affecting children.
- Enteral nutrition (EN) is a therapeutic option for active CD.
- Assessing treatment response patterns is crucial for managing pediatric CD.
Purpose of the Study:
- To characterize the response patterns to enteral nutrition (EN) in pediatric patients with moderate to severe Crohn's disease (CD).
Main Methods:
- Utilized a pattern recognition method to assess treatment response.
- Prospectively registered pediatric CD patients receiving EN from 1995-2005.
- Evaluated immediate (30-day) and long-term (90-day) responses to 4-week EN treatment.
Main Results:
- 80% of EN courses were completed in 31 pediatric patients.
- Immediate response: 67% complete response (CR), 22% partial response (PR), 11% no response (NR).
- Long-term response: 64% prolonged response (PRO), 36% loss of response (LR); median time to relapse was 8.3 months.
Conclusions:
- The developed model effectively describes response patterns to EN in pediatric CD.
- EN demonstrates significant efficacy in inducing both immediate and prolonged responses in pediatric CD patients.
- Understanding response patterns aids in optimizing EN therapy and predicting relapse in pediatric Crohn's disease.
Aim:
To describe the response pattern to enteral nutrition (EN) in paediatric patients with moderately to severely active Crohn's disease (CD).
Material And Methods:
A previously described method for assessment of response pattern to various treatments for CD was used. Patients who received EN during the 10-year period 1995-2005 were prospectively registered. Patient data, clinical outcome, time to relapse and subsequent need for treatment were extracted from the files. Four weeks treatment with polymeric ready-to-use liquid formula was given. The clinical outcome was assessed by pattern recognition of the disease course 30 days (immediate response) and 90 days (long-term response) after start of EN.
Results:
Thirty-one patients (17/14 M/F), median age 14 years (range 7.5 -19.8 years), received 46 courses of EN. Thirty-seven courses (80%) were completed. Immediate response: twenty-five courses (67%) led to complete response (CR), 8 (22%) to partial response (PR) and in 4 courses (11%) no response (NR) was achieved. Long-term response: 21 courses (64%) led to prolonged response (PRO), defined as either maintenance of complete response (CR) or partial response (PR), while 12 courses (36%) were followed by loss of response (LR). The median time to relapse was 8.3 months (range 0.5-39 months).
Conclusion:
We found our model of response pattern to be a useful instrument for the description of results obtained during EN in children with CD.
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