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- W4385362080 abstract "<h3></h3> This study aims to examine the changing practices of exclusive enteral nutrition (EEN) in paediatric Crohn’s disease (CD) including the influence of the 2021 ECCO-ESPGHAN guidelines and the COVID-19 pandemic. We analysed a prospectively identified cohort of newly diagnosed CD patients in two paediatric regional centres between 01/01/15 and 30/06/22. Data were retrospectively collected from electronic medical records. CD patients who received EEN were divided into biannual epochs for analysis. Continuous outcome measures were analysed using Mann-Whitney U or Chi-squared tests, and linear regression modelling for longitudinal comparison. Of 503 patients (62.2% male; median age 13.0 years, IQR: 10.9 – 14.8), primary EEN was used in 383 (76.1%) with a median course length of 8 weeks (IQR: 7.2 – 8.3). An increasing incidence of CD diagnosis and total EEN courses were observed (p=.01, figure 1). Remission/response rates, nasogastric tube (NG) usage and completion rates were examined; there were no changes in these parameters over time (p=.153, p=.913, p=.601, p=.337 respectively). Weight z-scores increased (pre-EEN -0.11 vs post-EEN 0.33, p≤.001). An increased rate of EEN as induction therapy was observed (first 12-months 66.7% vs last 87.7% - p=.004), with dual induction (EEN combined with biologics) an emerging strategy over time (first 12-months 2.6% vs last 18.7% - p=.018). (Figure 2). During the COVID-19 pandemic, primary EEN was less frequently used (63/96, 65.6% vs 320/407,78.6% - p=.007), completion rates were lower (41/68, 60.3% vs 236/315, 74.9% - p=.015) but remission rates were comparable (37/67, 53.7% vs 181/315, 57.3% - p=.59). Repeat courses of EEN occurred in 47/503 (9.3%) with no difference in remission rates (2nd course 23/47, 46.7% vs 1st course 217/383, 56.7% - p=.463). This large real-world cohort demonstrates EEN usage has increased together with CD incidence despite an increase in biologic use. The use of dual induction therapy with biologics is an emerging trend; further research is required to ascertain the clinical benefit above dose-optimised biologic induction and its cost-effectiveness." @default.
- W4385362080 created "2023-07-29" @default.
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- W4385362080 date "2023-07-01" @default.
- W4385362080 modified "2023-09-27" @default.
- W4385362080 title "OC1 Real world exclusive enteral nutrition practices over time in > 500 patients: persisting use as induction for paediatric crohn’s disease with emerging combination strategy with biologics" @default.
- W4385362080 doi "https://doi.org/10.1136/flgastro-2023-bspghan.1" @default.
- W4385362080 hasPublicationYear "2023" @default.
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