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Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP

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Paediatric Gastroenterology and Nutrition Unit, Hospital Complex Torrecárdenas, 04009 Almeria, Spain
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Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Esplugues del Llobregat, 08950 Barcelona, Spain
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Paediatric Gastroenterology and Nutrition Unit, Regional University Hospital of Malaga, 29011 Málaga, Spain
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Gastroenterology Unit, Hepatology and Nutrition, Central University Hospital of Asturias, 33011 Oviedo, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Virgen de la Concha, 49022 Zamora, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Maternal-Child Hospital, 35016 Las Palmas of Gran Canaria, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Virgen del Rocío, 41013 Seville, Spain
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Paediatric Gastroenterology and Nutrition Unit, University Hospital Son Espases, 07010 Palma de Mallorca, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital of the Canary Islands, 38320 Tenerife, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Fuenlabrada, Fuenlabrada, 28942 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Reina Sofía, 14004 Cordoba, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Complex, University of Albacete, 02008 Albacete, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital La Fe, 46009 Valencia, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Clinic San Carlos, 28040 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Maternal-Child Hospital Teresa Herrera, 15004 A Coruña, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, General University Hospital Gregorio Marañón, 28009 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Puerta de Hierro, 28220 Majadahonda, Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Clinic of Santiago, 15706 Santiago de Compostela, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital of Donostia, 20006 San Sebastian, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Lluís Alcanyís, Xátiva, 46800 Valencia, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital 12 de Octubre, 28041 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Río Hortega, 47012 Valladolid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital de Jerez, 11408 Jerez de la Frontera, Cádiz, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Paediatric Hospital Miguel Servet, 50009 Zaragoza, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Complex Ourense, 32616 Ourense, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Basurto, Bilbao, 48013 Vizcaya, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Niño Jesús, 28009 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Río Carrión, 34005 Palencia, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Jiménez Díaz Foundation, 28040 Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital San Pedro de Alcántara, 10003 Cáceres, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, Alcorcón Foundation, 28922 Alcorcón, Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Los Arcos del Mar Menor, 30739 Pozo Aledo, Murcia, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Hospital Infanta Sofía, 28709 San Sebastián de los Reyes, Madrid, Spain
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Paediatric Gastroenterology, Hepatology and Nutrition Unit, University Clinical Hospital, 46010 Valencia, Spain
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Institute of Biomedical Research in Malaga (IBIMA), 29010 Málaga, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(4), 1012; https://doi.org/10.3390/nu12041012
Received: 5 February 2020 / Revised: 3 April 2020 / Accepted: 3 April 2020 / Published: 7 April 2020
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 (μg/g) decreased significantly after EEN (830 [IQR 500–1800] to 256 [IQR 120–585] p < 0.0001). Patients with wPCDAI ≤ 57.5, FC < 500 μg/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. View Full-Text
Keywords: inflammatory bowel disease; Crohn’s disease; exclusive enteral nutrition; calprotectin; children; paediatric inflammatory bowel disease; Crohn’s disease; exclusive enteral nutrition; calprotectin; children; paediatric
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Moriczi, M.; Pujol-Muncunill, G.; Martín-Masot, R.; Jiménez Treviño, S.; Segarra Cantón, O.; Ochoa Sangrador, C.; Peña Quintana, L.; González Santana, D.; Rodríguez Martínez, A.; Rosell Camps, A.; Armas, H.; Barrio, J.; González de Caldas, R.; Rodríguez Salas, M.; Balmaseda Serrano, E.; Donat Aliaga, E.; Bodas Pinedo, A.; Vaquero Sosa, E.; Vecino López, R.; Solar Boga, A.; Moreno Álvarez, A.; Sánchez Sánchez, C.; Tolín Hernani, M.; Gutiérrez Junquera, C.; Martinón Torres, N.; Leis Trabazo, M.R.; Eizaguirre, F.J.; García Peris, M.; Medina Benítez, E.; Fernández Caamaño, B.; Vegas Álvarez, A.M.; Crespo Valderrábano, L.; Alonso Vicente, C.; Rubio Santiago, J.; Galera-Martínez, R.; García-Romero, R.; Ros Arnal, I.; Fernández Cebrián, S.; Lorenzo Garrido, H.; Viada Bris, J.F.; Velasco Rodríguez-Belvis, M.; Bartolomé Porro, J.M.; Blanco Rodríguez, M.; Barros García, P.; Botija, G.; Chicano Marín, F.J.; La Orden Izquierdo, E.; Crehuá-Gaudiza, E.; Navas-López, V.M.; Martín-de-Carpi, J. Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP. Nutrients 2020, 12, 1012.

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