Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of crohn's disease in adults

Fumihito Hirai, Hiroshi Ishihara, Shinichirou Yada, Motohiro Esaki, Tomohisa Ohwan, Ryoichi Nozaki, Shinya Ashizuka, Haruhiko Inatsu, Hidehisa Ohi, Kunihiko Aoyagi, Yohei Mizuta, Takayuki Matsumoto, Toshiyuki Matsui

Research output: Contribution to journalArticle

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Abstract

Background: One of the problems associated with infliximab (IFX) treatment for Crohn's disease (CD) is loss of response during maintenance therapy. Aims: The aim of this multicenter, retrospective, cohort study was to determine whether enteral nutrition (EN) added to the IFX therapy regimen is effective for maintaining remission in adult CD patients. Methods: Patients with CD who had started IFX therapy between April 2003 and March 2008 at any one of the seven participating medical centers and who met the following inclusion criteria were enrolled in the study: remission after triple infusions of IFX followed by IFX maintenance therapy every 8 weeks, and follow-up data available for ≥1 year. Remission was defined as a C-reactive protein (CRP) level of <0.3 mg/dL, and recurrence was defined as an increase in CRP to ≥1.5 mg/dL or shortening of the IFX interval. Patients were classified by EN dosage into two groups (EN group and non-EN group). The cumulative remission period and related factors were analyzed. Results: Of the 102 adult CD patients who met the inclusion criteria, 45 were in the EN group and 57 were in the non-EN group. The cumulative remission rate was significantly higher in the EN group than in the non-EN group (P = 0.009). Multivariate analysis revealed that EN was the only suppressive factor for disease recurrence (P = 0.01). Conclusions: The results demonstrate that among this CD patient cohort, EN combined with IFX maintenance treatment was clinically useful for maintaining remission.

Original languageEnglish
Pages (from-to)1329-1334
Number of pages6
JournalDigestive Diseases and Sciences
Volume58
Issue number5
DOIs
Publication statusPublished - May 1 2013

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Nutrition Therapy
Enteral Nutrition
Crohn Disease
C-Reactive Protein
Therapeutics
Recurrence
Infliximab
Cohort Studies
Multivariate Analysis
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

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Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of crohn's disease in adults. / Hirai, Fumihito; Ishihara, Hiroshi; Yada, Shinichirou; Esaki, Motohiro; Ohwan, Tomohisa; Nozaki, Ryoichi; Ashizuka, Shinya; Inatsu, Haruhiko; Ohi, Hidehisa; Aoyagi, Kunihiko; Mizuta, Yohei; Matsumoto, Takayuki; Matsui, Toshiyuki.

In: Digestive Diseases and Sciences, Vol. 58, No. 5, 01.05.2013, p. 1329-1334.

Research output: Contribution to journalArticle

Hirai, F, Ishihara, H, Yada, S, Esaki, M, Ohwan, T, Nozaki, R, Ashizuka, S, Inatsu, H, Ohi, H, Aoyagi, K, Mizuta, Y, Matsumoto, T & Matsui, T 2013, 'Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of crohn's disease in adults', Digestive Diseases and Sciences, vol. 58, no. 5, pp. 1329-1334. https://doi.org/10.1007/s10620-012-2374-2
Hirai, Fumihito ; Ishihara, Hiroshi ; Yada, Shinichirou ; Esaki, Motohiro ; Ohwan, Tomohisa ; Nozaki, Ryoichi ; Ashizuka, Shinya ; Inatsu, Haruhiko ; Ohi, Hidehisa ; Aoyagi, Kunihiko ; Mizuta, Yohei ; Matsumoto, Takayuki ; Matsui, Toshiyuki. / Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of crohn's disease in adults. In: Digestive Diseases and Sciences. 2013 ; Vol. 58, No. 5. pp. 1329-1334.
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AU - Hirai, Fumihito

AU - Ishihara, Hiroshi

AU - Yada, Shinichirou

AU - Esaki, Motohiro

AU - Ohwan, Tomohisa

AU - Nozaki, Ryoichi

AU - Ashizuka, Shinya

AU - Inatsu, Haruhiko

AU - Ohi, Hidehisa

AU - Aoyagi, Kunihiko

AU - Mizuta, Yohei

AU - Matsumoto, Takayuki

AU - Matsui, Toshiyuki

PY - 2013/5/1

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N2 - Background: One of the problems associated with infliximab (IFX) treatment for Crohn's disease (CD) is loss of response during maintenance therapy. Aims: The aim of this multicenter, retrospective, cohort study was to determine whether enteral nutrition (EN) added to the IFX therapy regimen is effective for maintaining remission in adult CD patients. Methods: Patients with CD who had started IFX therapy between April 2003 and March 2008 at any one of the seven participating medical centers and who met the following inclusion criteria were enrolled in the study: remission after triple infusions of IFX followed by IFX maintenance therapy every 8 weeks, and follow-up data available for ≥1 year. Remission was defined as a C-reactive protein (CRP) level of <0.3 mg/dL, and recurrence was defined as an increase in CRP to ≥1.5 mg/dL or shortening of the IFX interval. Patients were classified by EN dosage into two groups (EN group and non-EN group). The cumulative remission period and related factors were analyzed. Results: Of the 102 adult CD patients who met the inclusion criteria, 45 were in the EN group and 57 were in the non-EN group. The cumulative remission rate was significantly higher in the EN group than in the non-EN group (P = 0.009). Multivariate analysis revealed that EN was the only suppressive factor for disease recurrence (P = 0.01). Conclusions: The results demonstrate that among this CD patient cohort, EN combined with IFX maintenance treatment was clinically useful for maintaining remission.

AB - Background: One of the problems associated with infliximab (IFX) treatment for Crohn's disease (CD) is loss of response during maintenance therapy. Aims: The aim of this multicenter, retrospective, cohort study was to determine whether enteral nutrition (EN) added to the IFX therapy regimen is effective for maintaining remission in adult CD patients. Methods: Patients with CD who had started IFX therapy between April 2003 and March 2008 at any one of the seven participating medical centers and who met the following inclusion criteria were enrolled in the study: remission after triple infusions of IFX followed by IFX maintenance therapy every 8 weeks, and follow-up data available for ≥1 year. Remission was defined as a C-reactive protein (CRP) level of <0.3 mg/dL, and recurrence was defined as an increase in CRP to ≥1.5 mg/dL or shortening of the IFX interval. Patients were classified by EN dosage into two groups (EN group and non-EN group). The cumulative remission period and related factors were analyzed. Results: Of the 102 adult CD patients who met the inclusion criteria, 45 were in the EN group and 57 were in the non-EN group. The cumulative remission rate was significantly higher in the EN group than in the non-EN group (P = 0.009). Multivariate analysis revealed that EN was the only suppressive factor for disease recurrence (P = 0.01). Conclusions: The results demonstrate that among this CD patient cohort, EN combined with IFX maintenance treatment was clinically useful for maintaining remission.

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