Cyclic exclusive enteral nutrition could be used to maintain remission in children and adolescents with Crohn's disease, without use of immunosuppressive drugs, according to findings presented by Bénédicte Pigneur (Paris, France). In the CD-HOPE randomised trial, eligible patients were aged 6–17 years with a confirmed new diagnosis of Crohn's disease, or who were experiencing a relapse, and had completed a cycle of at least 6 weeks of exclusive enteral nutrition with clinical remission (weighted paediatric Crohn's disease activity index [wPCDAI] ≤12·5). 100 patients were randomly assigned to receive either cyclic exclusive enteral nutrition for 2 weeks every 8 weeks (n=49) or to daily supplementary nutrition (n=51). The primary objective was to compare relapse rates at 12 months (with relapse defined as a wPCDAI >12·5 at two consecutive visits). 24 (49%) patients receiving exclusive enteral nutrition had relapsed at 12 months, compared with 39 (76%) patients receiving supplementary nutrition (HR 0·48, 95% CI 0·29–0·80; p=0·0051).

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DOI: https://doi.org/10.1016/S2468-1253(21)00231-4

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