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Background <p>Crohn’s Disease exclusion diet (CDED) has been associated with positive outcomes in paediatric Crohn’s disease (CD) remission induction. This study prospectively compared clinical outcomes of CDED versus exclusive enteral nutrition (EEN).</p> Methods <p>CDED was implemented in January 2020 for induction in newly diagnosed CD patients with paediatric CD activity index (PCDAI) ≤ 40. Children induced with EEN (2014–2017) were included as a reference group. Clinical response (PCDAI decrease of 12.5 or &lt;10 points) and mucosal healing (MINI index &lt;8 points) were primary outcomes prospectively assessed in week 6. The secondary outcome, clinical relapse within the first year, was defined as therapy change or two consecutive fecal calprotectin levels &gt;500 µg/g.</p> Results <p>This study included 66 patients, 33 in each group, with significantly higher baseline PCDAI in the EEN group. Clinical response, observed in 76% of children on CDED and 82% receiving EEN, yielded aOR of 0.56 (95% CI = 0.08–3.50) for CDED vs EEN. Mucosal healing, achieved in 48% of children on CDED and 33% of EEN patients, was not associated with induction type (aOR = 1.74 [95% CI = 0.51–6.13]). CDED was associated with lower relapse risk (HR = 0.56 [95% CI = 0.32–0.99]); did not remain after adjustment.</p> Conclusion <p>CDED was not associated with less favourable clinical outcomes compared to EEN induction.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Exclusive enteral nutrition (EEN) is a well-established induction therapy for children with mild to moderate Crohn’s disease (CD), with tolerance representing one of its main limitations.</p> </ItemContent> <ItemContent> <p>In this prospective comparison of Crohn´s Disease Exclusion Diet (CDED) and EEN in newly diagnosed paediatric patients, CDED was not associated with significantly worse clinical outcomes compared to EEN.</p> </ItemContent> <ItemContent> <p>In routine clinical practice, CDED appears to be a suitable induction treatment option for children with mild to moderate CD, with outcomes comparable to EEN.</p> </ItemContent> </UnorderedList></p>

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Comparison of Crohn’s disease exclusion diet and exclusive enteral nutrition in prospectively followed paediatric patients with Crohn’s disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Jana Duskova,
  • Ondrej Hradsky,
  • Kristyna Zarubova,
  • Katarina Mitrova,
  • Jiri Bronsky,
  • Tereza Lerchova

摘要

Background

Crohn’s Disease exclusion diet (CDED) has been associated with positive outcomes in paediatric Crohn’s disease (CD) remission induction. This study prospectively compared clinical outcomes of CDED versus exclusive enteral nutrition (EEN).

Methods

CDED was implemented in January 2020 for induction in newly diagnosed CD patients with paediatric CD activity index (PCDAI) ≤ 40. Children induced with EEN (2014–2017) were included as a reference group. Clinical response (PCDAI decrease of 12.5 or <10 points) and mucosal healing (MINI index <8 points) were primary outcomes prospectively assessed in week 6. The secondary outcome, clinical relapse within the first year, was defined as therapy change or two consecutive fecal calprotectin levels >500 µg/g.

Results

This study included 66 patients, 33 in each group, with significantly higher baseline PCDAI in the EEN group. Clinical response, observed in 76% of children on CDED and 82% receiving EEN, yielded aOR of 0.56 (95% CI = 0.08–3.50) for CDED vs EEN. Mucosal healing, achieved in 48% of children on CDED and 33% of EEN patients, was not associated with induction type (aOR = 1.74 [95% CI = 0.51–6.13]). CDED was associated with lower relapse risk (HR = 0.56 [95% CI = 0.32–0.99]); did not remain after adjustment.

Conclusion

CDED was not associated with less favourable clinical outcomes compared to EEN induction.

Impact

Exclusive enteral nutrition (EEN) is a well-established induction therapy for children with mild to moderate Crohn’s disease (CD), with tolerance representing one of its main limitations.

In this prospective comparison of Crohn´s Disease Exclusion Diet (CDED) and EEN in newly diagnosed paediatric patients, CDED was not associated with significantly worse clinical outcomes compared to EEN.

In routine clinical practice, CDED appears to be a suitable induction treatment option for children with mild to moderate CD, with outcomes comparable to EEN.