{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:55:04Z","timestamp":1787230504144,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Both corticosteroids and exclusive enteral nutrition (EEN) have been used as induction therapy in children with Crohn's disease (CD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare in a nationwide study\u00a0the long\u2010term outcomes of children with CD receiving either EEN or corticosteroids as induction therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrieved data of all children diagnosed with CD (2005\u20132020) from the epi\u2010IIRN cohort covering 98% of the Israeli population. The primary outcome was time to complicated disease course (i.e., surgery, steroid\u2010dependency, or at least 2 biologic class). Patients were matched individually utilising propensity score adjustments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 410 children treated with EEN and 375 with corticosteroids without other treatments (median follow\u2010up, 4.73 [IQR: 2.2\u20137.2]\u2009years [1433 patient\u2010years]). For 274 matched children, the probability of a complicated course was higher with corticosteroids than EEN at 0.5, 3 and 5\u2009years (14% vs. 4%, 42% vs. 27% and 54% vs. 41%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0066), despite similar use of biologics. Steroid\u2010dependency (10% vs. 2%, 15% vs. 3%, and 20% vs. 5%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00018), and hospitalisations (20% vs. 11%, 37% vs. 26%, and 55% vs. 38%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) were higher with corticosteroids. During follow\u2010up, children receiving corticosteroids as induction treatment were more often further exposed to corticosteroids, and those on EEN were more often further exposed to nutritional treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Induction with EEN had no advantage over corticosteroids regarding survival probability of surgeries, biologic use and growth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EEN in paediatric CD is associated with lower long\u2010term risks of corticosteroid dependency and hospitalisation than corticosteroids. These results may lend support to favouring nutritional therapy in paediatric CD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.18028","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T06:25:31Z","timestamp":1715667931000},"page":"224-232","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Enteral nutrition compared with corticosteroids in children with Crohn's disease: A long\u2010term nationwide study from the epi\u2010IIRN"],"prefix":"10.1111","volume":"60","author":[{"given":"Luba","family":"Plotkin","sequence":"first","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&amp;D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Institute of Biochemistry, Food Science and Nutrition Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Buchuk","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&amp;D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rona","family":"Lujan","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&amp;D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gili","family":"Focht","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&amp;D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira","family":"Greenfeld","sequence":"additional","affiliation":[{"name":"Maccabi Health Services  Tel\u2010Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revital","family":"Kariv","sequence":"additional","affiliation":[{"name":"Maccabi Health Services  Tel\u2010Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiska Loewenberg","family":"Weisband","sequence":"additional","affiliation":[{"name":"Clalit Health Services, Clalit Research Institute  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natan","family":"Lederman","sequence":"additional","affiliation":[{"name":"Meuhedet Health Services  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Matz","sequence":"additional","affiliation":[{"name":"Leumit Health Services  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Dotan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Rabin Medical Center  Petah Tikva Israel"},{"name":"Faculty of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Reifen","sequence":"additional","affiliation":[{"name":"Institute of Biochemistry, Food Science and Nutrition Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5160-868X","authenticated-orcid":false,"given":"Dan","family":"Turner","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&amp;D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001896"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjy207"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0022-9"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114523000405"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2000.tb02821.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03431.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14253"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.03.010"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.62.2.123"},{"key":"e_1_2_9_11_1","first-page":"401","article-title":"A semielemental diet (Pregomin) as primary therapy for inducing remission in children with active Crohn's disease","volume":"28","author":"Terrin G","year":"2002","journal-title":"Ital J Pediatr"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03753-x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx060"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4103-8"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2019.22.1.72"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjx150"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181e2c724"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010012\u20102232\u20102"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S151339"},{"key":"e_1_2_9_20_1","unstructured":"Committee S. 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