Modified Crohn's disease exclusion diet is equally effective as exclusive enteral nutrition: Real‐world data

2021 ◽  
Author(s):  
Tena Niseteo ◽  
Sara Sila ◽  
Ivana Trivić ◽  
Zrinjka Mišak ◽  
Sanja Kolaček ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Real World ◽  
Real World Data ◽  
World Data ◽  
Exclusive Enteral Nutrition ◽  
Exclusion Diet

scholarly journals Evaluating the Cost-Effectiveness of Early Compared with Late or No Biologic Treatment to Manage Crohn’s Disease using Real-World Data

2019 ◽  
Vol 14 (4) ◽  
pp. 490-500 ◽  
Author(s):  
Nadia Pillai ◽  
Judith E Lupatsch ◽  
Mark Dusheiko ◽  
Matthias Schwenkglenks ◽  
Michel Maillard ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Health System ◽  
Real World ◽  
Transition Probabilities ◽  
Cost Effective ◽  
Real World Data ◽  
World Data ◽  
The Cost

Abstract Background and Aims We evaluated the cost-effectiveness of early [≤2 years after diagnosis] compared with late or no biologic initiation [starting biologics >2 years after diagnosis or no biologic use] for adults with Crohn’s disease in Switzerland. Methods We developed a Markov cohort model over the patient’s lifetime, from the health system and societal perspectives. Transition probabilities, quality of life, and costs were estimated using real-world data. Propensity score matching was used to ensure comparability between patients in the early [intervention] and late/no [comparator] biologic initiation strategies. The incremental cost-effectiveness ratio [ICER] per quality-adjusted life year [QALY] gained is reported in Swiss francs [CHF]. Sensitivity and scenario analyses were performed. Results Total costs and QALYs were higher for the intervention [CHF384 607; 16.84 QALYs] compared with the comparator [CHF340 800; 16.75 QALYs] strategy, resulting in high ICERs [health system: CHF887 450 per QALY; societal: CHF449 130 per QALY]. In probabilistic sensitivity analysis, assuming a threshold of CHF100 000 per QALY, the probability that the intervention strategy was cost-effective was 0.1 and 0.25 from the health system and societal perspectives, respectively. In addition, ICERs improved when we assumed a 30% reduction in biologic prices [health system: CHF134 502 per QALY; societal: intervention dominant]. Conclusions Early biologic use was not cost-effective, considering a threshold of CHF100 000 per QALY compared with late/no biologic use. However, early identification of patients likely to need biologics and future drug price reductions through increased availability of biosimilars may improve the cost-effectiveness of an early treatment approach.

Sa079 EVALUATING THE EFFECTIVENESS OF THE CROHN'S DISEASE EXCLUSION DIET (CDED) + PARTIAL ENTERAL NUTRITION (PEN) AS PRIMARY OR ADJUNCTIVE THERAPY: A 'REAL-WORLD’ TERTIARY IBD EXPERIENCE.

2021 ◽  
Vol 160 (6) ◽  
pp. S-412
Author(s):  
Claire Dimitroff ◽  
Darren Wong ◽  
Ashish Srinivasan ◽  
Robert Gilmore ◽  
Christopher F. Li Wai Suen ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Real World ◽  
Adjunctive Therapy ◽  
Exclusion Diet

Sa581 FEASIBILITY OF USING REAL-WORLD DATA FROM THE IMPROVECARENOW REGISTRY TO EXAMINE THE EFFICACY OF USTEKINUMAB FOR PEDIATRIC CROHN'S DISEASE

2021 ◽  
Vol 160 (6) ◽  
pp. S-560-S-561
Author(s):  
Steven Steiner ◽  
Richard B. Colletti ◽  
Eileen King ◽  
Shiran Chen ◽  
Kelly Olano ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Real World Data ◽  
World Data

scholarly journals Benefits of Exclusive Enteral Nutrition in Adults With Complex Active Crohn’s Disease: A Case Series of 13 Consecutive Patients

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Jianliang Liu ◽  
Jane M Andrews ◽  
Tarik Sammour ◽  
Robert V Bryant ◽  
Rachel Grafton ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Enterocutaneous Fistula ◽  
Case Series ◽  
Healthy Weight ◽  
Real World Data ◽  
Exclusive Enteral Nutrition ◽  
Perianal Fistulae ◽  
Objective Outcomes

Abstract Background and Aims Immunosuppressive therapy is routine for adults with complex active Crohn’s disease (CD), however carries risks, particularly in the setting of sepsis. Exclusive enteral nutrition (EEN) is widely used in paediatric CD, yet efficacy data in adults are sparse. This study evaluated outcomes of EEN in adults with complex active CD. Methods Between December 2016 and June 2018, 13 patients with complex active CD (range 20–74 years) managed at a single hospital received 2 or more weeks of EEN. Patients were offered EEN based on either malnutrition, contraindication to immunosuppression, or CD refractory to multiple therapies. Subjective and objective outcomes were recorded at 2 and 6 weeks and compared with baseline data. Results Nine of 13 patients experienced subjective improvement in wellbeing. Objective improvements included nine CRP decrements (median = 87.7 mg/L, IQR = 70.6 mg/L), nine serum albumin increments (median = 7 g/L, IQR = 4 g/L), and six gained weight (median = 3.6 kg, IQR = 3.0 kg). All five patients with complex abscess resolved without surgery. One ileocolic fistula and one enterocutaneous fistula achieved resolution without surgery. One of two perianal fistulae cases resolved without surgery. Seven of 10 patients initially thought to need surgery avoided it due to disease resolution. Only one of the three patients who proceeded to surgery sustained a post-operative complication. There were no EEN-associated complications. Conclusions In complex active CD, our real-world data show that EEN improves wellbeing, decreases inflammatory markers, leads to healthy weight gain, reduces need for surgical intervention, and reduces postoperative complications.

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