P612 Exclusive enteral nutrition in adults with active Crohn's disease is associated with decreased disease activity
Bibliographic record
Abstract
Background: Exclusive enteral nutrition (EEN) for 8–12 weeks, induces clinical remission in ∼70% of children and adolescents with active Crohn's disease (CD), and is considered comparable to steroids. We aimed to evaluate the impact of EEN in adults with active CD. Methods: Patients with active CD, referred for nutritional intervention with EEN in a tertiary inflammatory bowel disease (IBD) center, were enrolled. Baseline weight and nutritional needs were recorded. EEN was administered by oral polymeric formula with no other food items allowed. Patients were treated for at least three weeks. Physician's Global Assessment (PGA), Harvey Bradshaw Index (HBI), biomarkers (blood count, C-reactive protein [CRP], and albumin), weight, and body mass index (BMI) were recorded at baseline and at the end of EEN course. Results: A total of 33/42 patients with active CD (78%) who were offered EEN completed a full course. Eleven patients (33.3%) had newly diagnosed CD (<1.5 years), 16 (48.5%) were on stable-dose medications (immunomodulators and/or biologics), and two (6%) had no medical treatment. Disposition: male/female 25/8; mean age: 31.7±9.4 years; median disease duration – 7 (IQR 1–16) years. Montreal classification: L1 – 13 (39.4%), L2 – 1 (3%) L3 – 18 (54.5%); B1 – 15 (45.5%), B2 – 10 (30.3%), B3 – 4 (12.1%); P – 8 (24.2%). Baseline disease activity: PGA – mild 4, – moderate 20, and severe 8; mean HBI 6.7±4.7 points; median CRP 2.0 mg/dl (IQR 1.3–5.6). Mean EEN duration was 5.5 weeks (range 3–16). Baseline PGA improved after the EEN course in 31/33 patients (94%), this was in parallel to improvement in all activity indices: HBI 2.65±2.7 vs 6.78±4.7 vs (p<0.001); median CRP 1.01 (IQR 0.4–0.7) mg/dl vs 2 (IQR 1.3–5.6) vs mg/dl (p<0.001); mean albumin 4.2±0.4 mg/l vs 3.8±0.6 mg/l (p=0.003), respectively. There was no change in weight or BMI during EEN therapy. Notably, activity indices were also improved in a subgroup of long standing- CD patients: decrease in HBI 7.3±5.08 to 3.0±3.4 (p<0.001); CRP 4.66±5.7 mg/dl to 1.08±1.5 mg/dl (p=0.005). Finally, in 16 patients who received EEN as an add- on therapy to stable doses of their baseline therapy, HBI decreased from 6.5±5.8 to 2.4±3.3 (p=0.001) and CRP dropped from 3.5 (IQR 0.98–3.6) mg/dl to 0.88 (IQR 0.36–0.6)mg/dl (p=0.023). Conclusions: EEN is an effective therapeutic modality for active CD in adults. EEN therapy is associated with decreased clinical and biologic inflammatory activity, and may benefit patients with longstanding and newly diagnosed CD in need of a bridge or an add-on induction treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".