Dietary Therapy With the Crohn's Disease Exclusion Diet is a Successful Strategy for Induction of Remission in Children and Adults Failing Biological Therapy

Journal of Crohn's & Colitis
Rotem Sigall BonehArie Levine

Abstract

Loss of response [LoR] to biologics in Crohn's disease [CD] is a significant clinical problem. Dietary therapy as a treatment strategy in this setting has not been previously reported. We report the use of dietary strategies using enteral nutrition coupled with the Crohn's Disease Exclusion Diet [CDED] for LoR to infliximab or adalimumab as a single-centre experience. Patients with LoR to a biologic despite dose escalation or combination therapy were treated with partial enteral nutrition [PEN] by a polymeric formula and the CDED for 12 weeks. Paediatric patients with severe flares received 14 days of exclusive enteral nutrition followed by PEN + CDED as above. All patients were seen at weeks 6 and 12 for follow up. Current and prior treatment, Harvey Bradshaw Index [HBI], C-reactive protein [CRP] and albumin were recorded. Remission was defined as HBI <5 at week 6. Twenty-one patients, mean age 22.1 ± 8.9 years [11 adults and ten children] met study criteria. Seventeen patients [81%] had used combination therapy, and 10/21 [47.6%] had failed a second biologic. Seven patients had a prior intestinal resection. Dose escalation had failed in 13/21 [62%] patients. Clinical remission by physician's global assessment and HBI after 6 ...Continue Reading

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References

Feb 14, 2003·The New England Journal of Medicine·Filip BaertPaul Rutgeerts
Aug 26, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Elana A MaserGordon R Greenberg
May 2, 2007·Annals of Internal Medicine·William J SandbornPaul F Pollack
Aug 12, 2008·Alimentary Pharmacology & Therapeutics·R L WestC J van der Woude
Aug 27, 2009·European Journal of Gastroenterology & Hepatology·Takayuki YamamotoKoichi Matsumoto
Apr 16, 2010·The New England Journal of Medicine·Jean Frédéric ColombelUNKNOWN SONIC Study Group
Mar 24, 2011·The American Journal of Gastroenterology·Henit Yanai, Stephen B Hanauer
May 9, 2012·Gastroenterology·Jeffrey S HyamsAndreas Lazar
Nov 28, 2013·World Journal of Gastroenterology : WJG·Catherine L WallRichard B Gearry
Jun 10, 2014·Journal of Crohn's & Colitis·F M RuemmeleUNKNOWN European Society of Pediatric Gastroenterology, Hepatology and Nutrition
Jan 20, 2015·Gastroenterology·Dale LeeGary D Wu
Jul 3, 2015·Therapeutic Advances in Gastroenterology·Douglas L NguyenMatthew L Bechtold
Jul 5, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jennifer L JonesCorey A Siegel
Aug 15, 2015·International Journal of Colorectal Disease·Maki NakahigashiFumio Kobayashi

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Citations

Feb 16, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Ala K Shaikhkhalil, Wallace Crandall
Feb 9, 2019·The Cochrane Database of Systematic Reviews·Berkeley N LimketkaiGerard E Mullin
Oct 31, 2018·Alimentary Pharmacology & Therapeutics·Michael D PotterNicholas J Talley
Oct 16, 2019·Journal of Paediatrics and Child Health·Zubin Grover, George Alex
Dec 14, 2019·Crohn's & Colitis 360·Anita ChandrasekaranGauree Gupta Konijeti
Sep 19, 2020·Zeitschrift für Gastroenterologie·Jan de LaffolieUNKNOWN im Namen und Auftrag der AGs CEDATA und AG Ernährung und Diätetik/Ernährungsmedizin der GPGE
Apr 23, 2020·Case Reports in Veterinary Medicine·John C RoweAdam J Rudinsky
Jun 11, 2020·Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo·Gabriela Neves de SouzaGlauce Hiromi Yonamine
Mar 19, 2020·Current Gastroenterology Reports·Donald Goens, Dejan Micic
Jul 9, 2020·Biomedicines·Eran ZittanMarc S Berns
Sep 10, 2020·Nutrients·Antonio CorselloAlessandro Armuzzi
Oct 3, 2020·Nutrients·Hannah MortonJane Coad
Jun 23, 2019·Nutrients·Kelsea SandefurNeal D Barnard
Jun 27, 2019·Nutrients·Fernando Castro, Heitor S P de Souza
Apr 14, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Alice DayRobert V Bryant
Dec 5, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Ronald L Koretz
Dec 10, 2019·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Alexa N SassonMaitreyi Raman
Aug 29, 2020·Journal of the Academy of Nutrition and Dietetics·Alice S DayRobert V Bryant
Jan 17, 2021·Nutrients·Charlotte M VerburgtJohan E Van Limbergen
Apr 18, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Rotem Sigall BonehArie Levine
Feb 2, 2021·Gastroenterology Clinics of North America·Alexa N SassonAshwin N Ananthakrishnan
Sep 28, 2018·The Medical Journal of Australia·Lauren S WhiteMichael Kamm
Nov 3, 2020·European Journal of Pediatrics·Johan E Van LimbergenJ Peter de Winter
Dec 17, 2020·Nutrients·Marta Herrador-LópezVíctor Manuel Navas-López
Jan 25, 2021·Journal of the Academy of Nutrition and Dietetics·Alice S DayRobert V Bryant
Feb 16, 2021·World Journal of Experimental Medicine·Marina Moreira de CastroRaquel Franco Leal
Feb 3, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Ashwin N AnanthakrishnanSiew C Ng
Jan 14, 2021·Journal of Crohn's & Colitis·Vera PetersDaisy M A E Jonkers
Mar 7, 2021·Nutrients·Ugo CucinottaValeria Dipasquale
Apr 4, 2021·Nutrients·Judith WellensJoão Sabino
Jun 30, 2019·Gastroenterology·João SabinoJean-Fréderic Colombel
May 27, 2021·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Pabitra SahuRakesh K Tandon
Jun 3, 2021·Nutrients·Kohei Sugihara, Nobuhiko Kamada
Jun 3, 2021·Nutrients·Luca Scarallo, Paolo Lionetti
Jul 25, 2021·Journal of Clinical Medicine·Malgorzata Matuszczyk, Jaroslaw Kierkus
Aug 3, 2021·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Tena NiseteoIva Hojsak
Aug 28, 2021·Nutrients·Liliana Łykowska-SzuberIwona Krela-Kaźmierczak
Jun 24, 2021·Journal of Crohn's & Colitis·Tim RaineGarret Cullen

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