Table 1.
Summary of studies including EN in meta-analysis
| Ref. no. | Author | Study design | Group | Therapy for Crohn's disease | Average dose of EN | Total number | Long-term remission or response | Definition of clinical remission or response | (%) Duration of follow-up period | |
|---|---|---|---|---|---|---|---|---|---|---|
| Year | Randomization | Number | Percent | |||||||
| [40] | Tanaka et al. | Retrospective | EN + | IFX (5 mg/kg) + EN (> 3762 kJ/day) | NA | 51 | 30 | 58.8 | Reduction in HBI score, or number of fistula | 16 weeks after IFX last dose |
| 2006 | Observational | EN − | IFX (5 mg/kg) without EN | NA | 59 | 22 | 37.3 | Increase in HBI score, or number of fistula | 16 weeks from IFX last dose | |
| [41] | Yamamoto et al. | Prospective | EN + | IFX (5 mg/kg) + EN (≥1200 kcal/day) | NA | 32 | 25 | 78.1 | CDAI score < 150 | 56 weeks after remission |
| 2010 | Observational | EN − | IFX (5 mg/kg) without EN | NA | 24 | 16 | 66.7 | CDAI score ≥ 150 | 56 weeks from remission | |
| [42] | Sazuka et al. | Retrospective | EN + | IFX (5 mg/kg) + EN (≥ 600 kcal/day) | NA | 29 | 23 | 79.3 | CDAI score < 150 | Last visit in follow-up |
| 2012 | Observational | EN − | IFX (5 mg/kg) + EN (<600 kcal/day) | NA | 45 | 22 | 48.9 | CDAI score ≥ 150, etc | Median follow-up from remission: 85 weeks | |
| [43] | Hirai et al. | Retrospective | EN + | IFX (5 mg/kg) + EN (≥ 900 kcal/day) | 1233 ± 62 (mean ± SE) | 45 | 31 | 68.9 | CRP < 0.3 mg/dL | Last visit in follow-up |
| 2013 | Observational | EN − | IFX (5 mg/kg) + EN (< 900 kcal/day) | 535 ± 32 (mean ± SE) | 57 | 24 | 42.1 | CRP ≥ 1.5 mg/dL, etc |
Mean follow-up from remission EN + group: 525.3 days (75.0 weeks) EN− group: 558.9 days (79.8 weeks) |
|
| [44] | Kamata et al. | Retrospective | EN + | IFX (5 mg/kg) + EN (≥ 900 kcal/day) | 1246 ± 350 (mean ± SE) | 28 | 27 | 96.4 | Clinical remission | Last visit in follow-up |
| 2015 | Observational | EN − | IFX (5 mg/kg) + EN (< 900 kcal/day) | 142 ± 238 (mean ± SE) | 97 | 77 | 79.4 | Clinical symptoms, etc |
Mean follow-up from remission EN + group: 799 days (114 weeks) EN- group: 771 days (110 weeks) |
|
| [45] | Hirai et al. | Prospective | EN + | IFX (5 mg/kg)/ADA (40 mg) + EN (≥ 900 kcal/day prescribEN) | NA | 37 | 24 | 64.9 | CDAI score < 200 | Last visit in follow-up |
| 2018 | Observational | EN − | IFX (5 mg/kg)/ADA (40 mg) only | NA | 35 | 22 | 62.9 | CDAI score ≥ 200 | 2 years (104 weeks) from IFX/ADA first dose | |
| [51] | Hisamatsu et al. | Prospective | EN + | IFX (10 mg/kg) + EN (900–1200 kcal/day) | NA | 14 | 11 | 78.6 | CDAI score < 150 | Last visit in follow-up |
| 2018 | Randomized | EN − | IFX (10 mg/kg) without EN | NA | 6 | 3 | 50.0 | Termination of maintenance therapy | 56 weeks form IFX 10 mg/kg dose | |
| [52] | Moroi et al. | Retrospective | EN + | IFX (5 mg/kg)/ADA (40 mg) + EN (≥ 900 kcal/day) | NA | 27 | 13 | 48.1 | Clinical remission | Last visit in follow-up |
| 2018 | Observational | EN − | IFX (5 mg/kg)/ADA (40 ng) + EN (< 900 kcal/day) | NA | 154 | 75 | 48.7 | Clinical relapse | At most 10 years (521 weeks) from IFX first dose | |
| [53] | Sugita et al. | Retrospective | EN + | ADA (40 mg) + EN (≥ 900 kcal/day) | 1044 ± 192 (mean ± SD) | 25 | 19 | 76.0 | HBI score < 5 | Last visit in follow-up |
| 2018 | Observational | EN − | ADA(40 mg) + EN (< 900 kcal/day) | 88 ± 200 (mean ± SD) | 92 | 45 | 48.9 | HBI score ≥ 5, etc |
Mean follow-up from remission EN + group: 1282 days (183 weeks) EN − group: 1340 days (191 weeks) |
|
IFX infliximab, NA not applicable, HBI Harvey–Bradshaw Index, ADA adalimumab, CDAI Crohn's Disease Activity Index, EN elemental nutrition, CRP C-reactive protein