Use of exclusive enteral nutrition in adults with Crohn’s disease: A review

Table 1 Studies of adults that compared exclusive enteral nutrition with corticosteroid therapy

Ref.	Year	Country	Age (SD or range)	Received no previous CD treatment (% of EEN group)	Number of participants		% that achieved remission (intention to treat)		Significant difference (P value)	Remission criteria	Number that did not complete EEN intervention, n (%)		% that achieved remission (treatment completed)
					EEN	CS	EEN	CS			Formula un-palatable	Other reason	EEN	CS
Engelman et al[19]	1993	England	23-54	Not stated	7	4	100%	100%	NS	HBI < 6.0	0 (0)	0	100%	100%
1Gassull et al[27]	2002	Europe	31.3 (3.3)	50%	20	19	20%	79%	0.0005	VHAI < 120	5 (25)	0	27%	79%
2Gassull et al[27]	2002	Europe	30.8 (4.1)	43.50%	23	19	52%	79%	NS	VHAI < 120	4 (17)	0	63%	79%
González-Huix et al[23]	1993	Spain	31.1 (4.1)	47%	15	17	8%	88%	NS	VHAI < 120	0 (0)	0	80%	88%
Gorard et al[21]	1993	England	31.6 (3.0)	50%	22	20	45%	85%	< 0.05	HBI - remission not defined , mean < 2	9 (41)	2	91%	89%
Lindor et al[25]	1992	United States	34.7 (26-64)	33%	9	10	50%	33%	NS	CDAI decrease > 100 points	3 (33)	1	60%	63%
Lochs et al[28]	1991	Europe	27.5 (1.5)	Not stated	55	52	53%	79%	< 0.01	CDAI decrease > 100 points or > 40%	7 (13)	0	60%	85%
Malchow et al[29]	1990	Europe	30.1 (11.5)	20%	51	44	41%	71%	< 0.05	CDAI decrease > 100 points or > 40%	20 (39)	0	71%	91%
Mantzaris et al[20]	1996	Greece	Not stated	20%	10	10	40%	70%	NS	CDAI < 150 or decrease > 100 points	0 (0)	0	40%	70%
Okada et al[26]	1990	Japan	21.0 (3.3)	100%	10	10	80%	30%	< 0.01	HBI < 1	0 (0)	0	80%	30%
O'Moráin et al[22]	1984	England	31.9 (15-60)	100%	11	10	82%	80%	NS	HBI - remission not defined. Mean < 3	2 (18)	0	100%	100%
Zoli et al[24]	1997	Italy	33.5 (15.9)	Not stated	12	10	67%	50%	NS	HBI < 3	1 (8)	1	80%	50%

^1,2Gassull et al had two EEN arms:

¹High oleic fatty acid formula;

²High linoleic fatty acid formula. CD: Crohn’s disease; CDAI: Crohn’s disease activity index; CS: Corticosteroids; EEN: Exclusive enteral nutrition; HBI: Harvey Bradshaw Index; NS: Non-significant; VHAI: Van Hees activity index.