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Res."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adalimumab\u00a0monotherapy\u00a0can suppress gut inflammation and induce remission in active Crohn\u2019s disease but\u00a0has some limitations. Exclusive enteral nutrition (EEN) is recommended for patients with mild to moderate Crohn\u2019s disease (CD), but implementation is challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of adalimumab combined with partial enteral nutrition (PEN) in the induction\u00a0therapy for\u00a0Crohn\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective cohort study was designed and a total of 56 patients with active CD who met the criteria for enteral nutrition (EN) treatment in our hospital were selected. The baseline data of all patients were collected including age, sex and other general information. The changes in fecal calprotectin, C-reactive protein (CRP), albumin(Alb), hemoglobin (Hb), platelets (Plt), erythrocyte sedimentation rate (ESR), Crohn\u2019s disease activity index score (CDAI), simple endoscopic score (SES-CD) and body mass index (BMI) were compared between\u00a0the\u00a0adalimumab combined with enteral nutrition (ADA+EN) group (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200937) the adalimumab group (ADA) (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200919)\u00a0at week 0 (W0) and treatment outcomes at week 12(W12). Additionally, the differences between the two groups before and after treatment were evaluated. Then the ADA+EN group was divided into an adalimumab combined with exclusive enteral nutrition subgroup (ADA+EEN) and an adalimumab combined with partial nutrition subgroup (ADA+PEN) according to enteral nutrition intake. The changes in fecal calprotectin, CRP, Alb, Hb, Plt, ESR and CDAI, SES-CD and BMI were compared between the \u00a0ADA+EEN group and the ADA+PEN group at week 0 (W0) and treatment outcomes at week 12(W12).\u00a0The differences between the two groups before and after treatment were evaluated. To evaluate the effectiveness of the two treatments on patients\u2019 quality of life, nutritional recovery and body composition, patients in the ADA+EN group were needed to complete the Inflammatory Bowel Disease Questionnaire (IBDQ),\u00a0EQ-5D-5L, the EuroQol visual analogue scale (EQ-VAS) and body composition analysis.A total of 28 patients completed all questionnaires and body composition analyses at week 0 and week 12, including 10 patients in the ADA+EEN group and 18 patients in the ADA+PEN group, respectively. The differences of in IBDQ, EQ-5D-5L and body composition analysis were compared between the two groups at week 0 (W0) and treatment outcomes at week 12(W12). Additionally, the differences between the two groups before and after treatment were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      These investigated indexes such as calprotectin, Hb, Plt,\u00a0ESR, Alb, BMI, CRP, CDAI and SES-CD scores were significantly different before and after treatment \u00a0in the ADA+EN group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). However, fecal calprotectin, Hb, SES-CD scores and Alb in the ADA group were not statistically significantly different from\u00a0W0 to W12 (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05). The fecal calprotectin and CDAI scores in the ADA+EN group were significantly lower than those in the ADA group after treatment. The differences in all factors before and after treatment between the ADA+PEN group and the ADA+EEN group were statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). However, there was no significant difference between the two groups at week 12 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adalimumab combined with EN are more effective than ADA monotherapy\u00a0in terms of endoscopy and clinical remission. By comparing the investigated indicators such as calprotectin, Hb, Plt, ESR\u00a0,CRP and SES-CD scores, it was proven that adalimumab combined with partial enteral nutrition or exclusive enteral nutrition has the same remission effect in induced Crohn\u2019s disease. The combination of biological agents and partial nutrition can improve medical order compliance, psychological burden and quality of life. Therefore, adalimumab combined with partial nutrition can be used as the first-line treatment for CD induced remission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00011-023-01828-7","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T14:05:08Z","timestamp":1704204308000},"page":"199-209","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prospective study of an adalimumab combined with partial enteral nutrition in the induction period of Crohn\u2019s disease"],"prefix":"10.1007","volume":"73","author":[{"given":"Sisi","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiting","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,2]]},"reference":[{"issue":"10080","key":"1828_CR1","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/S0140-6736(16)31711-1","volume":"389","author":"J Torres","year":"2017","unstructured":"Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. 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