Crohn's disease exclusion diet as an add-on to antitumor necrosis factor-α therapy in children with moderate-to-severe Crohn's disease

This retrospective pediatric study evaluated whether adding the Crohn’s Disease Exclusion Diet (CDED) with partial enteral nutrition (PEN) to anti-TNF-α therapy improves outcomes in children with moderate-to-severe Crohn’s disease. Thirty-seven patients were compared: one group received anti-TNF therapy alone, while the other received combined anti-TNF therapy with CDED + PEN at diagnosis.

Children receiving combination therapy had more severe disease at baseline but demonstrated greater early clinical improvement and faster normalization of inflammatory markers (CRP and ESR) by week 8 compared with anti-TNF therapy alone. Clinical remission rates were similar between groups, but reductions in disease activity scores were significantly larger in the combined therapy group. Trends toward improved weight gain were also observed and sustained over one year.

Overall, the findings suggest that CDED combined with PEN may accelerate the effectiveness of anti-TNF therapy in pediatric Crohn’s disease, particularly in patients with severe disease activity. Larger prospective studies are needed to confirm these benefits and define the role of combination nutritional and biologic therapy in pediatric care.

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