Efficacy of a concomitant elemental diet to reduce the loss of response to adalimumab in patients with intractable Crohn's disease

Sugita, Naoko; Watanabe, Kenji; Kamata, Noriko; Yukawa, Tomomi; Otani, Koji; Hosomi, Shuhei; Nagami, Yasuaki; Tanaka, Fumio; Taira, Koichi; Yamagami, Hirokazu; Tanigawa, Tetsuya; Shiba, Masatsugu; Watanabe, Toshio; Tominaga, Kazunari; Kabata, Daijiro; Shintani, Ayumi; Fujiwara, Yasuhiro

doi:10.1111/jgh.13969

Cited by 13 publications

(14 citation statements)

References 33 publications

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“…EN does not directly induce an increase in anti-TNF-alpha antibody blood concentration or reduce antibody production. However, an increasing number of recent reports have shown how the use of EN in combination with an anti-TNF-alpha antibody is clinically useful due to the add-on effect of EN itself [40][41][42][43][44][45][51][52][53]. In the present review, in which these studies were meta-analyzed, the pooled OR for maintenance of remission or relapse with EN was 2.23 in the fixed effects model and 2.19 in the random effects model.…”

Section: Discussionmentioning

confidence: 54%

“…enteral nutrition vs conventional therapy: 1), and three articles where the end point was not clinical remission or response. Based on the results of these exclusions, nine articles meeting all criteria were included in this meta-analysis [40][41][42][43][44][45][51][52][53] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…1). In two of the articles [52,53], the number of relapse events was not accurately described, but shown only in a graph. We, therefore, confirmed the number of events by communicating with the author via email.…”

Section: Study Selectionmentioning

confidence: 99%

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Efficacy of enteral nutrition in patients with Crohn’s disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis

et al. 2019

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Enteral nutrition (EN) is effective in Crohn's disease (CD) patients and has been shown to have an inhibitory effect on loss of response to anti-tumor necrosis factor (TNF)-alpha antibody therapy; however, the current level of evidence is not sufficient. The objective of this meta-analysis was to determine whether EN in combination anti-TNF-alpha antibody therapy is useful in maintaining remission. PubMed was used to identify all relevant studies. A total of nine articles were identified including one randomized control trial, two prospective cohort studies, and six retrospective cohort studies. We performed a meta-analysis on all these articles to assess the remission maintenance effect of EN (n = 857). The remission or response maintenance effect in the EN group was 203/288 (70.5%), which was higher than 306/569 (53.8%) in the non-EN group. The odds ratio for long-term remission or response using fixed effects model and random effects model were 2.23 (95% CI 1.60-3.10) and 2.19 (95% CI 1.49-3.22), respectively. The usefulness of EN was unclear in two prospective studies that were conducted immediately after remission induction with anti-TNF-alpha antibody therapy was detected. Differences in the definition of relapse and the observation period among articles were considered to be limitations. This analysis suggests that EN is effective for maintaining remission in patients already in remission or response as a result of anti-TNF-alpha antibody maintenance therapy.

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Section: Discussionmentioning

confidence: 54%

Section: Study Selectionmentioning

confidence: 99%

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Efficacy of enteral nutrition in patients with Crohn’s disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis

et al. 2019

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“…In this biologics era, the position of EN therapy has also changed. Recently, the combination use of anti-TNFα agents and EN therapy has been studied [92][93][94][95][96][97][98][99][100] (Table 2). Hirai et al [96] reported that EN combination group had better cumulative remission maintenance rate than IFX alone group in their retrospective analysis of patients with CD who received remission maintenance IFX therapy.…”

Section: (4) Sarcopeniamentioning

confidence: 99%

“…Nguyen et al [98] demonstrate that a combination of infliximab and EN is more effective at inducing and maintaining clinical remission among patients with CD than infliximab alone in a metaanalysis. Recently, it has also been reported with respect to efficacy of EN against loss of response to anti-TNFα agents [95,99,100] . and to remove antigenic mucosal stimuli [101] .…”

Section: (4) Sarcopeniamentioning

confidence: 99%

Significance of nutritional treatment for patients with inflammatory bowel disease in the era of biologics

Yokoyama¹,

Iida²,

Nakase³

2019

OJGH

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Review Article OJGH (2019) 2:20 Significance of nutritional treatment for patients with inflammatory bowel disease in the era of biologics Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease (CD), is a chronic gastrointestinal tract inflammatory disorder. Although its etiology remains unknown, it has been reported that nutrition is involved in the onset of IBD. Patients with IBD often experience malnutrition due to malabsorption and increased energy requirements. Malnutrition is a serious issue for patients with IBD, especially in young people. Growth retardation characterized by delayed skeletal maturation and onset of puberty is a representative complication. In addition, immunosuppression, osteoporosis, and sarcopenia are important issues. Functional foods and diets have been known to alleviate gastrointestinal inflammation by modulating inflammatory cytokines. Furthermore, appropriate nutritional treatment has been reported to be effective on the induction and maintenance of remission in patients with IBD, especially with CD. Conversely, there are negative reports regarding the efficacy of nutritional therapy in patients with IBD. Recently, various new therapeutic agents such as biologics have emerged as key drugs in IBD treatment. In this new era, the efficacy of nutritional treatment, including combination therapy with biologics, should be reconsidered to improve the quality of life in patients with IBD. In this review, the nutritional treatment for patients with IBD is reviewed, and the latest evidence is provided.

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Role of Diet in the Development and Management of Crohn’s Disease

Goens

Micic

2020

Curr Gastroenterol Rep

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Efficacy of a concomitant elemental diet to reduce the loss of response to adalimumab in patients with intractable Crohn's disease

Abstract: Concomitant ED therapy reduced ADA-LOR in IFX-intolerant or refractory patients in a dose-related manner. Reductions in the TNF-α levels by concomitant ED intake may contribute to reduce ADA-LOR in CD patients.

Cited by 13 publications

References 33 publications

Efficacy of enteral nutrition in patients with Crohn’s disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis

Efficacy of enteral nutrition in patients with Crohn’s disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis

Significance of nutritional treatment for patients with inflammatory bowel disease in the era of biologics

Role of Diet in the Development and Management of Crohn’s Disease

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