Therapeutic Value of Exclusive and Partial Enteral Nutrition in Adult Patients with Moderate to Severe Crohn's Disease with Ustekinumab for Induction of Remission.

Abstract

Background: Crohn's disease (CD) is a chronic, nonspecific transmural inflammatory bowel disease. Enteral nutrition (EN) is a vital adjunctive treatment for CD; however, its precise therapeutic role remains unknown.

Aims: This study aims to investigate the therapeutic value of exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) in moderate to severe CD in adults induced by ustekinumab (UST).

Methods: This retrospective analysis included 50 adult patients with moderate to severe CD who achieved remission wish UST therapy. Patients were divided into the EEN group (n = 24) and the PEN group (n = 26) based on their mode of EN. The dosage of UST for intravenous infusion was weight-based, followed by a subcutaneous injection of 90 mg UST as induction therapy 8 weeks after the first administration. We compared the clinical remission rate, endoscopic remission rates, body mass index (BMI), nutritional indicators, and inflammatory markers between the two groups after 8 weeks of treatment.

Results: After treatment, both the Crohn's Disease Activity Index and Crohn's Disease Endoscopic Index of Severity decreased in both groups, with the EEN group showing significantly higher clinical and endoscopic remission rates than the PEN group (P < 0.05). Both groups also exhibited a significant increase in BMI and nutritional indicators after treatment, with a greater increase in the EEN group (P < 0.05). Inflammatory markers significantly decreased in both groups, with the EEN group experiencing a greater reduction (P < 0.05). Additionally, the overall incidence of adverse reactions in both groups was low and improved with treatment adjustments.

Conclusion: EN significantly improved clinical conditions and nutritional status and reduced inflammation levels and disease activity in adult patients with moderate to severe CD undergoing UST-induced remission. EEN was found to be superior to PEN in these aspects.