Effectiveness of an ‘half elemental diet’ as maintenance therapy for Crohn's disease: a randomized‐controlled trial

• Published in: Alimentary pharmacology & therapeutics Vol. 24; no. 9; pp. 1333 - 1340
• Main Authors: TAKAGI, S., UTSUNOMIYA, K., KURIYAMA, S., YOKOYAMA, H., TAKAHASHI, S., IWABUCHI, M., TAKAHASHI, H., KINOUCHI, Y., HIWATASHI, N., FUNAYAMA, Y., SASAKI, I., TSUJI, I., SHIMOSEGAWA, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2006; Blackwell
• Subjects: Adult; Biological and medical sciences; Crohn Disease - diet therapy; Digestive system; Enteral Nutrition - methods; Female; Follow-Up Studies; Food, Formulated; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Other diseases. Semiology; Parenteral Nutrition - methods; Pharmacology. Drug treatments; Recurrence; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Treatment Outcome; Crohn disease; Diet therapy; Efficiency; Maintenance treatment; Randomised controlled trial; Digestive diseases; Intestinal disease; Elemental diet; Inflammatory disease
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2006.03120.x

Summary Background Although thiopurines have a proven role in maintenance therapy for Crohn's disease, an alternative therapy is needed for patients intolerant or resistant to thiopurines. Aim To evaluate the effectiveness of home enteral nutrition as a maintenance therapy regimen in which half of the daily calorie requirement is provided by an elemental diet and the remaining half by a free diet. We refer to this home enteral nutrition therapy as ‘half elemental diet’. Methods Between 2002 and 2005, 51 patients in remission from two hospitals were randomly assigned to a half elemental diet group (n = 26) or a free diet group (n = 25). The primary outcome measure of this study was the occurrence of relapse over the 2‐year period. Results The relapse rate in the half elemental diet group was significantly lower [34.6% vs. 64.0%; multivariate hazard ratio 0.40 (95% CI: 0.16–0.98)] than that in the free diet group after a mean follow‐up of 11.9 months. Compliance was similar in the two groups. No adverse event occurred in any of the patients throughout the study. Conclusion This randomized‐controlled trial shows the effectiveness of an half elemental diet, which is a promising maintenance therapy for Crohn's disease patients.