Swaminath A, et al. – An analysis was performed to examine if current literature supported the use of Exclusive enteral nutrition (EEN) vs. corticosteroids (CS) in paediatric Crohn's disease populations. In a paediatric population, the researchers found no difference in efficacy between EEN and CS in the induction of remission in Crohn's disease. Exploratory analyses proposed that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing.

• The researchers identified all studies with comparator arms of exclusive enteral nutrition and exclusive corticosteroids, with remission clearly defined by searching eight online databases.

• The inclusion criteria was met by 9 studies among 2795 identified sources.
• Out of these, 8 (n = 451) had data that could be abstracted into the meta-analysis.
• In inducing remission, Exclusive enteral nutrition was as effective as corticosteroids (OR = 1.26 [95% CI 0.77, 2.05]) in paediatric Crohn's disease.
• The researchers found no difference between Exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's (OR = 1.61 [95% CI .87, 2.98]) or relapsed (OR = 0.76 [95% CI .29-1.98]).
• Among patients receiving Exclusive enteral nutrition, intestinal healing was significantly more likely compared to corticosteroids (OR = 4.5 [95% CI 1.64, 12.32]).
• No difference was found in the frequency of biomarker normalisation including CRP (OR = 0.85 [95% CI .44, 1.67]) and faecal calprotectin (OR 2.79 [95% CI .79-10.90]).