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Microbiota signatures and mucosal healing in the use of enteral nutrition therapy v. corticosteroids for the treatment of children with Crohn's disease: a systematic review and meta-analysis.
- Source :
- British Journal of Nutrition; 10/28/2023, Vol. 130 Issue 8, p1385-1402, 18p
- Publication Year :
- 2023
-
Abstract
- Corticosteroids (CS) and exclusive and partial enteral nutrition (EEN and PEN) are effective therapies in paediatric Crohn's disease (CD). This systematic review of randomised controlled trials (RCT) and cohort studies analyses the impact of EEN/PEN v. CS on intestinal microbiota, mucosal healing as well as other clinically important outcomes, including clinical remission, relapse, adherence, adverse events and health-related quality of life (HRQL) in paediatric CD. Three RCT (n 76) and sixteen cohort studies (n 1104) compared EEN v. CS. With limited available data (one RCT), the effect on intestinal microbiome indicated a trend towards EEN regarding Shannon diversity. Based on two RCT, EEN achieved higher mucosal healing than CS (risk ratio (RR) 2·36, 95 % CI (1·22, 4·57), low certainty). Compared with CS, patients on EEN were less likely to experience adverse events based on two RCT (RR 0·32, 95 % CI (0·13, 0·80), low certainty). For HRQL, there was a trend in favour of CS based on data from two published abstracts of cohort studies. Based on thirteen cohort studies, EEN achieved higher clinical remission than CS (RR 1·18, 95 % CI (1·02, 1·38), very low certainty). Studies also reported no important differences in relapse and adherence. Compared with CS, EEN may improve mucosal healing with fewer adverse events based on RCT data. While limited data indicate the need for further trials, this is the first systematic review to comprehensively summarise the data on intestinal microbiome, mucosal healing and HRQOL when comparing enteral nutrition and CS in paediatric CD. [ABSTRACT FROM AUTHOR]
- Subjects :
- CROHN'S disease
CINAHL database
MEDICAL databases
ADRENOCORTICAL hormones
META-analysis
CONFIDENCE intervals
INFLAMMATORY bowel diseases
MEDICAL information storage & retrieval systems
GUT microbiome
SYSTEMATIC reviews
MUCOUS membranes
TREATMENT effectiveness
DISEASE relapse
COMPARATIVE studies
REMISSION induction
DRUGS
QUALITY of life
QUALITY assurance
ENTERAL feeding
PATIENT compliance
ADVERSE health care events
MEDLINE
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 00071145
- Volume :
- 130
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- British Journal of Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 172021144
- Full Text :
- https://doi.org/10.1017/S0007114523000405