Short- and long-term therapeutic efficacy of nutritional therapy and corticosteroids in paediatric Crohn's disease

被引:134
作者
Canani, R. Berni
Terrin, G.
Borrelli, O.
Romano, M. T.
Manguso, F.
Coruzzo, A.
D'Armiento, F.
Romeo, E. F.
Cucchiara, S.
机构
[1] Univ Roma La Sapienza, Gastroenterol Unit, Div Paediat Gastroenterol Unit, I-00161 Rome, Italy
[2] Univ Naples Federico II, Dept Paediat, Naples, Italy
[3] Univ Naples Federico II, Dept Expt Med, Naples, Italy
[4] Univ Naples Federico II, Dept Pathol, Naples, Italy
关键词
children; corticosteroids; inflammatory bowel disease; mucosal inflammation; nutritional therapy; polymeric diet;
D O I
10.1016/j.dld.2005.10.005
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. Comparative data on the therapeutic efficacy of different enteral nutrition formulas and corticosteroids to obtain clinical remission and to induce mucosal healing influencing long-term disease course in paediatric Crohn's disease are still scarce. Aims. To investigate the efficacy of nutritional therapy using three different formulas versus corticosteroids to achieve clinical remission as well as to induce intestinal mucosal healing in active Crohn's disease children. Duration of remission and effect on growth recovery were also assessed. Patients and methods. Clinical, laboratory, endoscopic and histological data of all new diagnosed active Crohn's disease paediatric cases were retrospectively recorded and reviewed. Thirty-seven children (median age 12.1 years) received nutritional therapy (12 polymeric; 13 semi-elemental; 12 elemental diet) and 10 subjects (median age 12.4 years) received corticosteroids. Results. Similar clinical remission rate were observed after 8 weeks of treatment: 86.5% children receiving nutritional therapy versus 90% treated with corticosteroids. Improvement in mucosal inflammation occurred in 26 out of 37 (64.8%) patients on nutritional therapy and in 4 out of 10 (40%) children on steroids (p < 0.05). Finally, seven subjects on nutritional therapy and none on corticosteroids achieved complete mucosal healing (p < 0.005) at the end of the treatment. Nutritional therapy was more effective than corticosteroids in improving nutritional status and linear growth recovery. Compared to corticosteroids, the duration of clinical remission was longer in the nutritional therapy groups without differences among the three different formulas. Conclusions. In children with active Crohn's disease, nutritional therapy is more effective than corticosteroids to improve intestinal inflammation and to maintain a more sustained clinical remission. (c) 2005 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:381 / 387
页数:7
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