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Effectiveness of an ‘half elemental diet’ as maintenance therapy for Crohn's disease: a randomized-controlled trial

  1. S. TAKAGI1,
  2. K. UTSUNOMIYA1,
  3. S. KURIYAMA2,
  4. H. YOKOYAMA1,
  5. S. TAKAHASHI1,
  6. M. IWABUCHI3,
  7. H. TAKAHASHI3,
  8. S. TAKAHASHI1,
  9. Y. KINOUCHI1,
  10. N. HIWATASHI4,
  11. Y. FUNAYAMA5,
  12. I. SASAKI5,
  13. I. TSUJI2,
  14. T. SHIMOSEGAWA1

Article first published online: 9 OCT 2006

DOI: 10.1111/j.1365-2036.2006.03120.x

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 24, Issue 9, pages 1333–1340, November 2006

Additional Information

How to Cite

TAKAGI, S., UTSUNOMIYA, K., KURIYAMA, S., YOKOYAMA, H., TAKAHASHI, S., IWABUCHI, M., TAKAHASHI, H., TAKAHASHI, S., KINOUCHI, Y., HIWATASHI, N., FUNAYAMA, Y., SASAKI, I., TSUJI, I. and SHIMOSEGAWA, T. (2006), Effectiveness of an ‘half elemental diet’ as maintenance therapy for Crohn's disease: a randomized-controlled trial. Alimentary Pharmacology & Therapeutics, 24: 1333–1340. doi: 10.1111/j.1365-2036.2006.03120.x

Author Information

  1. 1

    Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai

  2. 2

    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai

  3. 3

    Department of Gastroenterology, Sendai Medical Centre, Sendai

  4. 4

    Department of Gastroenterology, Iwaki Kyoritsu General Hospital, Iwaki

  5. 5

    Division of Biological Regulation and Oncology, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

*Dr S. Takagi, Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba, Sendai 980-8574, Japan. E-mail: stakagi@int3.med.tohoku.ac.jp

Publication History

  1. Issue published online: 16 OCT 2006
  2. Article first published online: 9 OCT 2006
  3. Publication data Submitted 18 June 2006 First decision 27 June 2006 Resubmitted 8 August 2006 Accepted 8 August 2006

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Summary

Background

Although thiopurines have a proven role in maintenance therapy for Crohn's disease, an alternative therapy is needed for patients intolerant or resistant to thiopurines.

Aim

To evaluate the effectiveness of home enteral nutrition as a maintenance therapy regimen in which half of the daily calorie requirement is provided by an elemental diet and the remaining half by a free diet. We refer to this home enteral nutrition therapy as ‘half elemental diet’.

Methods

Between 2002 and 2005, 51 patients in remission from two hospitals were randomly assigned to a half elemental diet group (n = 26) or a free diet group (n = 25). The primary outcome measure of this study was the occurrence of relapse over the 2-year period.

Results

The relapse rate in the half elemental diet group was significantly lower [34.6% vs. 64.0%; multivariate hazard ratio 0.40 (95% CI: 0.16–0.98)] than that in the free diet group after a mean follow-up of 11.9 months. Compliance was similar in the two groups. No adverse event occurred in any of the patients throughout the study.

Conclusion

This randomized-controlled trial shows the effectiveness of an half elemental diet, which is a promising maintenance therapy for Crohn's disease patients.

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