RT Journal Article
SR Electronic
T1 Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn’s disease?
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 767
OP 770
DO 10.1136/adc.2006.103416
VO 92
IS 9
A1 A F Rodrigues
A1 T Johnson
A1 P Davies
A1 M S Murphy
YR 2007
UL http://adc.bmj.com/content/92/9/767.abstract
AB Background: Active Crohn’s disease can be treated using liquid diet therapy (LDT), but non-adherence may limit success, necessitating corticosteroid therapy. Whole-protein polymeric formula (PF) seems to be much more palatable than amino acid-based elemental formula (EF) and thus may significantly improve adherence to LDT.Aim: To compare adherence to LDT using PF versus EF.Methods: Success in completing a 6-week course of LDT, need for nasogastric tube administration of formula and use of LDT for relapses were compared between children presenting with active disease and treated with EF (n = 53) and children given PF (n = 45).Results: Remission rates were similar (EF 64%, 95% CI 51 to 77 vs PF 51%, 95% CI 37 to 66; p>0.15). 72% (95% CI 60 to 84) given EF completed the initial course of LDT compared with 58% (95% CI 44 to 72) given PF (p = 0.15). Of those failing to complete the initial course, 13% on EF and 16% on PF gave up by choice (non-adherence), the remainder stopping due to treatment failure. Nasogastric administration was more frequent with EF (55%, 95% CI 42 to 68) compared to PF (31%, 95% CI 17 to 45) (p = 0.02). Among those treated successfully at first presentation, LDT was used for 28% of relapses in the EF group (95% CI 12 to 44) and 39% in the PF group (95% CI 19 to 59) (p>0.2) over the next year.Conclusion: PF did not effect adherence to LDT but was associated with significantly reduced need for nasogastric tube administration of formula.