OC20 Exclusive enteral nutrition to induce biochemical remission in Crohn’s disease: characteristics of treatment failure
Bibliographic record
Abstract
<h3></h3> Mucosal healing is considered the goal of Crohn’s disease (CD) treatment<sup>1</sup> with Faecal Calprotectin (FCP) <250ug/g confirming good response. Treatment with exclusive enteral nutrition (EEN) has previously shown a rising FCP in 40% of patients despite apparent treatment compliance.<sup>2</sup> This study measures clinical disease activity scores and FCP across 8 weeks treatment with EEN comparing disease distribution between biochemical responders (FCP <250ug/g) and non-responders. Patients treated with EEN, were identified retrospectively via clinical records between 2018–2021. Inclusion criteria: <18 years, newly diagnosed CD, completed 8 weeks. FCP and weighted Paediatric Crohn’s Disease Activity Index (wPCDAI) were measured baseline, week 4 and 8. Montreal classification for disease site at enrolment, age and gender documented. A total of 100 patients met inclusion criteria, with 30 having complete data. Table 1 shows demographic of patients with complete data. 21/30 patients achieved clinical remission (wPCDAI <12 points), 3 patients wPCDAI did not fall all had increased FCP. 9 achieved FCP <250ug/g. Their average baseline FCP were lower compared to non-responders [723 (SD 263) v 2138.3 (SD 1906), p>0.05]. 8 children (26%) FCP increased at week 8, with no significant difference in disease distribution from responders (chi L1, L2, L3 p>0.2). These 8 children tended to have a higher baseline wPCDAI compared to responders (20.6 (SD 21.8) v 8.9 (SD 11.3), p=0.06). Week 8 50% had wPCDAI <12. This series reports data on real clinical practice. Treatment for CD with 8 weeks EEN, results in 70% having a clinical improvement, yet a 70% chance of failing to respond biochemically (FCP<250mmol/L) i.e. failed mucosal healing. Disease distribution does not predict failure. High dropout rates, poor biochemical response alongside baseline clinical symptoms, should be considered when offering EEN therapy. <h3>References</h3> van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL, <i>et al</i>. The medical management of paediatric crohn’s disease: An ecco-espghan guideline update. <i>Journal of Crohn’s and Colitis.</i> 2020;<b>15</b>(2):171–94. Gerasimidis K, Nikolaou CK, Edwards CA, McGrogan P. Serial fecal calprotectin changes in children with Crohn’s disease on treatment with exclusive enteral nutrition: associations with disease activity, treatment response, and prediction of a clinical relapse. <i>Journal of Clinical Gastroenterology.</i> 2011;<b>45</b>(3):234–9.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".