Naslov
Primary therapeutic role of enteral nutrition vrs. corticosteroids in paediatric patients with CD: A retrospective comparison study

Autori
Hojsak, Iva ; Abdović, Slaven ; Mišak, Zrinjka ; Jaklin-Kekez, Alemka, Jadrešin, Oleg ; Kolaček Sanja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
WCPGHAN

Mjesto i datum
Slapovi Iguaçu, Brazil, 08.2008

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
enteral nutrition; corticosteroids; paediatric patients

Sažetak
Objective: There are still controversies for optimal treatment of active Crohn&#8217; s Disase (CD). Both, enteral nutrition (EN) and corticosteroids (CS) are commonly used for induction of remission in patients with CD. The aim of this study was to investigate duration of remission (time until first relapse) in children with active CD treated with EN in comparison to patients treated with CS. Methods: Data of all newly diagnosed CD patients (n=47) treated in Children&#8217; s Hospital Zagreb from 1997 to 2007 were retrospectively analyzed (27 male and 20 female, age range 9-17.8 years). As a first line therapy for remission induction, EN was introduced in 30 (63, 8 %) patients vs 16 patients (34, 04%) treated primarily with CS. EN consisted of a polymeric formula, given exclusively for 5-6 weeks. CS were introduced in the dose of 1 mg/kg for 4 weeks &#8211; after that period steroids were withdrawn by following a stepwise decrees. All patients received concomitantly either mesalamine (N=16 ; 34, 8%), azathiprine (N=9 ; 19, 6%) or both (N=16 ; 45, 7%) with the aim to maintain the remission. Reasons for treatment with CS were: predominantly colonic disease, very severe form of the disease, treatment started in other hospital, strong preference of the child. Results: From 30 patients who were treated with EN, 21 patients (70%) established remission which lasted from 4 months to 5 years (mean 17, 6 months). In all patients in whom EN failed, remission was achieved with CS. In CS group, all patients entered remission. However, duration of remission was significantly shorter in the steroid group (range: 3-12 mo ; mean 6 mo ; p<0.01). There was no statistical difference between EN and CS groups regarding age at diagnosis and duration of illness. However, majority of patients successfully treated with EN had either ileal or ileocoecal disease (71, 4%), compared with steroid group in which 81, 25% had ileocolonic and 18, 75% colonic disease. Conclusion: In our paediatric patients with CD, CS successfully induced remission in all patients compared to 70% of children treated with EN. Nevertheless, patients treated with EN had significant longer remission compared to patients treated with CS. Objective: There are still controversies for optimal treatment of active Crohn&#8217; s Disase (CD). Both, enteral nutrition (EN) and corticosteroids (CS) are commonly used for induction of remission in patients with CD. The aim of this study was to investigate duration of remission (time until first relapse) in children with active CD treated with EN in comparison to patients treated with CS. Methods: Data of all newly diagnosed CD patients (n=47) treated in Children&#8217; s Hospital Zagreb from 1997 to 2007 were retrospectively analyzed (27 male and 20 female, age range 9-17.8 years). As a first line therapy for remission induction, EN was introduced in 30 (63, 8 %) patients vs 16 patients (34, 04%) treated primarily with CS. EN consisted of a polymeric formula, given exclusively for 5-6 weeks. CS were introduced in the dose of 1 mg/kg for 4 weeks &#8211; after that period steroids were withdrawn by following a stepwise decrees. All patients received concomitantly either mesalamine (N=16 ; 34, 8%), azathiprine (N=9 ; 19, 6%) or both (N=16 ; 45, 7%) with the aim to maintain the remission. Reasons for treatment with CS were: predominantly colonic disease, very severe form of the disease, treatment started in other hospital, strong preference of the child. Results: From 30 patients who were treated with EN, 21 patients (70%) established remission which lasted from 4 months to 5 years (mean 17, 6 months). In all patients in whom EN failed, remission was achieved with CS. In CS group, all patients entered remission. However, duration of remission was significantly shorter in the steroid group (range: 3-12 mo ; mean 6 mo ; p<0.01). There was no statistical difference between EN and CS groups regarding age at diagnosis and duration of illness. However, majority of patients successfully treated with EN had either ileal or ileocoecal disease (71, 4%), compared with steroid group in which 81, 25% had ileocolonic and 18, 75% colonic disease. Conclusion: In our paediatric patients with CD, CS successfully induced remission in all patients compared to 70% of children treated with EN. Nevertheless, patients treated with EN had significant longer remission compared to patients treated with CS.

Izvorni jezik
Engleski

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