A novel uc exclusion diet and antibiotics for treatment of mild to moderate pediatric ulcerative colitis
| Autor: | Michal Yaakov, Dror Weiner, Eytan Wine, Arie Levine, Johan Van Limbergen, Lindsey Albenberg, Anthony R. Otley, Naomi Pressman, Chen Sarbagili-Shabat |
|---|---|
| Přispěvatelé: | Paediatric Gastroenterology, Amsterdam Gastroenterology Endocrinology Metabolism, APH - Digital Health, APH - Health Behaviors & Chronic Diseases |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.drug_class Remission Antibiotics Nutritional Status Pediatric ulcerative colitis Pilot Projects Article Eating Therapeutic approach Maintenance therapy Metronidazole Internal medicine medicine Humans Exclusion diet TX341-641 Prospective Studies Microbiome Child Nutrition and Dietetics Nutrition. Foods and food supply business.industry Remission Induction Amoxicillin medicine.disease Ulcerative colitis Anti-Bacterial Agents Intention to Treat Analysis Diet Treatment Treatment Outcome Doxycycline Patient Compliance Colitis Ulcerative Drug Therapy Combination Female Open label business Food Science |
| Zdroj: | Nutrients, 13(11):3736. Multidisciplinary Digital Publishing Institute (MDPI) Nutrients Volume 13 Issue 11 Nutrients, Vol 13, Iss 3736, p 3736 (2021) |
| ISSN: | 2072-6643 |
| Popis: | Background: As the microbiome plays an important role in instigating inflammation in ulcerative colitis (UC), strategies targeting the microbiome may offer an alternative therapeutic approach. The goal of the pilot trial was to evaluate the potential efficacy and feasibility of a novel UC exclusion diet (UCED) for clinical remission, as well as the potential of sequential antibiotics for diet-refractory patients to achieve remission without steroids. Methods: This was a prospective, single-arm, multicenter, open-label pilot study in patients aged 8–19, with pediatric UC activity index (PUCAI) scores > 10 on stable maintenance therapy. Patients failing to enter remission (PUCAI < 10) on the diet could receive a 14-day course of amoxycillin, metronidazole and doxycycline (AMD), and were re-assessed on day 21. The primary endpoint was intention-to-treat (ITT) remission at week 6, with UCED as the only intervention. Results: Twenty-four UCED treatment courses were given to 23 eligible children (mean age: 15.3 ± 2.9 years). The median PUCAI decreased from 35 (30–40) at baseline to 12.5 (5–30) at week 6 (p = 0.001). Clinical remission with UCED alone was achieved in 9/24 (37.5%). The median fecal calprotectin declined from 818 (630.0–1880.0) μg/g at baseline to 592.0 (140.7–1555.0) μg/g at week 6 (p > 0.05). Eight patients received treatment with antibiotics after failing on the diet 4/8 (50.0%) subsequently entered remission 3 weeks later. Conclusion: The UCED appears to be effective and feasible for the induction of remission in children with mild to moderate UC. The sequential use of UCED followed by antibiotic therapy needs to be evaluated as a microbiome-targeted, steroid-sparing strategy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|