Remission duration according to dietary adherence in paediatric mild to moderate Crohn's disease treated with CDED +...

The Crohn's Disease Exclusion Diet (CDED) combined with partial enteral nutrition (PEN) is a dietary therapy developed to induce and maintain remission in patients with Crohn's disease.

The aim of study was to evaluate the duration of clinical remission in paediatric patients with mild to moderate Crohn's disease undergoing a Crohn's Disease Exclusion Diet (CDED) combined with partial enteral nutrition (PEN), stratified by degree of dietary adherence.

A retrospective, single-centre observational study was conducted with the participation of paediatric patients who underwent CDED + PEN treatment in the period from June 2019 to June 2025. Twelve-month clinical follow-up was available in 41 subjects. The following were assessed: BMI-SDS index (group 6-17 years), erythrocyte sedimentation rate, C-reactive protein, faecal calprotectin, Pediatric Crohn's Disease Activity Index (PCDAI) scale score, and adherence. Time to relapse was analysed.

Data from 54 patients aged 6-17 years were analysed. Mean baseline PCDAI was 15.47 ±12.44. Clinical remission (PCDAI < 10) was achieved in 69% at week 6 and in 77% at week 12. The median time to relapse was 8.2 months. A statistically significant factor influencing the duration of remission was identified. The median remission time was 11.97 months (IQR: 7.60-25.98; mean: 18.75 ±16.18) in patients with adherence ≥ 80% (n = 17) and 5.63 months (IQR: 4.97-8.03; mean: 6.88 ±4.02) with adherence < 80% (n = 10). The mean difference between groups was 11.9 months (95% CI: 3.3-20.5); Welch's test p = 0.009. An F-test confirmed unequal variances (p = 0.0002).

Suboptimal adherence remains a key modifiable predictor of relapse. Data support consideration of CDED + PEN as a viable long-term strategy in motivated families and underscore the pivotal role of the dietitian in monitoring adherence and nutritional status.