Evidence map›Paper›PMID 34580154›Full record

ReviewBMJ open gastroenterology2021

Review of exclusive enteral therapy in adult Crohn's disease.

Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.

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  18. Let thy food be thy medicine.Frontline gastroenterology · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Nikola Mitrev *Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia.ORCID 0000-0001-9273-7445
Hin Huang *Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia viraj.kariyawasam@gmail.com hinhuang3013@gmail.com.
Barbara HannahDepartment of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia.
Viraj Chandana KariyawasamGastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia viraj.kariyawasam@gmail.com hinhuang3013@gmail.com.
Blacktown & Mount Druitt Hospital · AUConcord Repatriation General Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExclusive enteral nutrition (EEN) is a potentially effective but underused therapy for Crohn's disease (CD) in adults. It is first-line induction treatment for paediatric patients but remains a second-line or third-line therapy in adults.

objectiveTo analyse the evidence for EEN in adult patients with CD, and summarise this in a narrative review.

methodsIn April/May 2020 and July 2021, a literature search was performed using the Medical Subject Headings (MeSH) terms: 'Crohn's disease', 'CD', 'inflammatory bowel disease', 'IBD', 'exclusive enteral nutrition', 'enteral nutrition', 'EEN', in PubMed, Scopus, Cochrane. Additional studies were obtained from references of search result articles as well as general reading. Studies with adult patients with CD treated with EEN were selected. 79 articles of relevance were found. Where data in adults were lacking, data from paediatric studies as extrapolated with care.

resultsEEN in adult patients been shown to improve clinical, biomarker, endoscopic and radiologic measures of disease activity. EEN avoids the potential adverse effects of recurrent corticosteroids for induction such as metabolic derangements and opportunistic infections. EEN has also demonstrated benefits among adult patients with fistulising and stricturing CD. It may avoid surgery in such patients. Preoperative EEN has also been shown to reduce postoperative complications and recurrence. There appears to be benefits in combing EEN with antitumour necrosis factor agents, however, benefits of combination therapy with other biologics are less clear. A major drawback of EEN therapy in adults has been poor compliance. More palatable polymeric formulations improved patient education and dietitian support may overcome this. Evidence in adults is limited to small studies, often with suboptimal control arms and lack of blinding. Larger scale studies with improved study design are needed to confirm these beneficial effects.

conclusionDespite limitations in evidence EEN should be considered in treating adults with CD.

Indexed as

Crohn DiseaseAdrenal Cortex HormonesAdultChildEndoscopyEnteral NutritionHumansRemission InductionAdrenal Cortex Hormonescrohn's diseaseenteral nutritionenteral/parenteral nutrition

Identifiers

PMID34580154
PMCPMC8477235
OpenAlexW3204461123

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.