title: Short- and long-term therapeutic efficacy of nutritional therapy and corticosteroids in paediatric Crohn's disease.
abstract: BACKGROUND
  Comparative data on the therapeutic efficacy of different enteral nutrition formulas and corticosteroids to obtain clinical remission and to induce mucosal healing influencing long-term disease course in paediatric Crohn's disease are still scarce.
  
  
  OBJECTIVE
  To investigate the efficacy of nutritional therapy using three different formulas versus corticosteroids to achieve clinical remission as well as to induce intestinal mucosal healing in active Crohn's disease children. Duration of remission and effect on growth recovery were also assessed.
  
  
  METHODS
  Clinical, laboratory, endoscopic and histological data of all new diagnosed active Crohn's disease paediatric cases were retrospectively recorded and reviewed. Thirty-seven children (median age 12.1 years) received nutritional therapy (12 polymeric; 13 semi-elemental; 12 elemental diet) and 10 subjects (median age 12.4 years) received corticosteroids.
  
  
  RESULTS
  Similar clinical remission rate were observed after 8 weeks of treatment: 86.5% children receiving nutritional therapy versus 90% treated with corticosteroids. Improvement in mucosal inflammation occurred in 26 out of 37 (64.8%) patients on nutritional therapy and in 4 out of 10 (40%) children on steroids (p < 0.05). Finally, seven subjects on nutritional therapy and none on corticosteroids achieved complete mucosal healing (p < 0.005) at the end of the treatment. Nutritional therapy was more effective than corticosteroids in improving nutritional status and linear growth recovery. Compared to corticosteroids, the duration of clinical remission was longer in the nutritional therapy groups without differences among the three different formulas.
  
  
  CONCLUSIONS
  In children with active Crohn's disease, nutritional therapy is more effective than corticosteroids to improve intestinal inflammation and to maintain a more sustained clinical remission.
authors.affiliation: Department of Paediatrics, University of Naples Federico II, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Berni Canani
authors.forename: G
authors.initials: G
authors.lastname: Terrin
authors.forename: O
authors.initials: O
authors.lastname: Borrelli
authors.forename: M T
authors.initials: MT
authors.lastname: Romano
authors.forename: F
authors.initials: F
authors.lastname: Manguso
authors.forename: A
authors.initials: A
authors.lastname: Coruzzo
authors.forename: F
authors.initials: F
authors.lastname: D'Armiento
authors.forename: E F
authors.initials: EF
authors.lastname: Romeo
authors.forename: S
authors.initials: S
authors.lastname: Cucchiara
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005526:Food, Formulated; D006801:Humans; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones