THERAPEUTIC EFFICACY OF CYCLIC HOME ELEMENTAL ENTERAL ALIMENTATION INCROHNS-DISEASE - JAPANESE COOPERATIVE CROHNS-DISEASE STUDY

Crohn's disease (CD) often flares up and requires frequent hospitaliza tion and/or surgery. Cyclic home elemental enteral alimentation (C-HEE A) was developed to prevent flare-up of CD and to minimize patient hos pitalization. However, its therapeutic efficacy has not been studied i n a large patient population. Therefore, questionnaires were sent to m embers of the Inflammatory Bowel Disease (IBD) Research Group of Japan to evaluate the therapeutic efficacy of C-HEEA and to define the fact ors that may affect the efficacy of the treatment. Data for 410 patien ts (C-HEEA-treated n = 322; drug-treated n = 88) were collected from 2 9 institutions and analysis showed the following results. The cumulati ve remission and nonhospitalization rates of the C-HEEA treated group were significantly higher than the rates of the drug-treated group in all patients and in those with ileitis and ileo-colitis (P < 0.0001, P < 0.001, and P < 0.01, respectively), but no significant difference w as noted in patients with colitis. Cumulative remission and non-hospit alization rates were also influenced by the daily calorie content of t he elemental diet (ED); more than 1200 kcal of the ED per day was foun d to be more effective than lower amounts to maintain remission and to prevent hospitalization. The therapeutic efficacy of C-HEEA was shown to be superior to that of drug treatment in patients with CD with hea l involvement, and it is suggested that more than 1200 kcal per day sh ould be supplied by the ED to enhance its therapeutic efficacy.