{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:03:29Z","timestamp":1784693009272,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T00:00:00Z","timestamp":1531699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014421","name":"EA Pharma Co., Ltd.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100014421","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The aim of this study was to clarify the additional effect of a concomitant elemental diet (ED) for patients with Crohn's disease on maintenance anti\u2010tumor necrosis factor\u2010\u03b1 antibody (anti\u2010TNF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Crohn's disease patients who received anti\u2010TNF induction therapy were enrolled. Patients who achieved clinical response (defined as delta Crohn's disease activity index [CDAI]\u00a0&gt;\u00a070 and CDAI\u00a0&lt;\u00a0200) at 10\u201314\u00a0weeks after the start of infliximab or adalimumab were included. Eligible patients took a tolerability test of ED (900\u00a0kcal\/day) for 3\u00a0days. Then, patients who preferred concomitant ED and whose ED tolerance was confirmed were allocated to the ED group and given Elental 900\u00a0kcal\/day or more. Other patients were allocated to the non\u2010ED group. The primary endpoint was the cumulative remission rate at 2\u00a0years after baseline. Clinical relapse was defined as CDAI\u00a0&gt;\u00a0200 and\/or need for additional treatment. Adherence to the ED was confirmed at each visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010two patients were included. Thirty\u2010seven were allocated to the ED group, and 35 were allocated to the non\u2010ED group. The cumulative remission rate at 2\u00a0years was not significantly different between the two groups (60.9% <jats:italic>vs<\/jats:italic> 56.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.98). Adherence to the ED in the ED group was relatively low, and only 11 patients were maintained on an ED of 900\u00a0kcal\/day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The addition of ED for Crohn's disease patients who responded to initial anti\u2010TNF induction therapy was not found to improve outcomes. The efficacy of concomitant ED in other clinical settings, such as loss of response, needs to be clarified in the future (UMIN000009789).<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14361","type":"journal-article","created":{"date-parts":[[2018,6,23]],"date-time":"2018-06-23T14:05:15Z","timestamp":1529762715000},"page":"132-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Effect of a concomitant elemental diet with maintenance anti\u2010tumor necrosis factor\u2010\u03b1 antibody therapy in patients with Crohn's disease: A multicenter, prospective cohort study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5493-5675","authenticated-orcid":false,"given":"Fumihito","family":"Hirai","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Fukuoka University Chikushi Hospital  Fukuoka 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