Trial reportGut1993
Initial response and subsequent course of Crohn's disease treated with elemental diet or prednisolone.
Trial report in Gut, 1993. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Enteral nutrition for maintenance of remission in Crohn's disease.The Cochrane database of systematic reviews · 2018Pooled it
- Enteral nutritional therapy for induction of remission in Crohn's disease.The Cochrane database of systematic reviews · 2018Pooled it
- Interventions for growth failure in childhood Crohn's disease.The Cochrane database of systematic reviews · 2005Pooled it
- Corticosteroids for maintaining remission of Crohn's disease.The Cochrane database of systematic reviews · 2000Pooled it
- Synergistic Benefits of Dietary Strategies in the Management of IBD.Current gastroenterology reports · 2025Review
- Mechanisms of Action of Exclusive Enteral Nutrition and Other Nutritional Therapies in Crohn's Disease.Nutrients · 2024Review
- Elemental Diet as a Therapeutic Modality: A Comprehensive Review.Digestive diseases and sciences · 2024Review
- Diet as therapeutic intervention in Crohn's disease.Przeglad gastroenterologiczny · 2022Review
- Review of exclusive enteral therapy in adult Crohn's disease.BMJ open gastroenterology · 2021Review
- Nutritional Treatment in Crohn's Disease.Nutrients · 2021Review
- EEN Yesterday and Today … CDED Today and Tomorrow.Nutrients · 2020Review
- Dietary lipids fuel GPX4-restricted enteritis resembling Crohn's disease.Nature communications · 2020Article
- Development of a prognostic model for one-year surgery risk in Crohn's disease patients: A retrospective study.World journal of gastroenterology · 2020Article
- Review
- Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn's Disease.Journal of the Canadian Association of Gastroenterology · 2019Article
- A Review of Dietary Therapy for IBD and a Vision for the Future.Nutrients · 2019Article
- Chronic Inflammatory Diseases: Are We Ready for Microbiota-based Dietary Intervention?Cellular and molecular gastroenterology and hepatology · 2019Review
- Treatment of Active Crohn's Disease with Exclusive and Partial Enteral Nutrition: A Pilot Study in Adults.Inflammatory intestinal diseases · 2018Article
- Recipe for IBD: can we use food to control inflammatory bowel disease?Seminars in immunopathology · 2018Review
- Medications that cause weight gain and alternatives in Canada: a narrative review.Diabetes, metabolic syndrome and obesity : targets and therapy · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Elemental diet is as effective as corticosteroids in the treatment of previously untreated Crohn's disease. It is unclear whether a poor nutritional state is a prerequisite for efficacy of elemental diet, whether previously treated patients respond as well, or how duration of remission using elemental diet compares with corticosteroid induced remission. Forty two patients with active Crohn's disease were stratified for nutritional state and randomised to receive Vivonex TEN 2.1 l/day for four weeks, or 0.75 mg prednisolone/kg/day for two weeks and subsequent reducing doses. Nine of 22 (41%) patients assigned to nutritional treatment were intolerant of the diet. Thirty patients completed four weeks treatment. Disease activity decreased on elemental diet from mean (SEM) 4.8 (0.9) to 1.7 (0.6), p < 0.05, and on prednisolone from 5.3 (0.5) to 1.9 (0.6), p < 0.05. For each treatment, nourished and malnourished patients responded similarly. Patients with longstanding disease responded as well as newly diagnosed patients. The probability of maintaining remission at six months was 0.67 after prednisolone, 0.28 after elemental diet, and at one year was 0.35 after prednisolone and 0.09 after elemental diet, p < 0.05. When tolerated, elemental diet is as effective in the short term as prednisolone in newly and previously diagnosed Crohn's disease, and its benefit is independent of nutritional state. The subsequent relapse rate after elemental diet induced remission, however, is greater than after treatment with prednisolone.
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What OpenQuestion holds
Registered trials
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.