Format

Send to

Choose Destination
Perm J. 2017;21. doi: 10.7812/TPP/17-009.

Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial.

Author information

1
Chief of the Inflammatory Bowel Disease Section at Akita City Hospital in Japan. mchiba@m2.gyao.ne.jp.
2
Chief of the Gastrointestinal Endoscopy Section at Akita City Hospital in Japan. ac070289@akita-city-hp.jp.
3
Chief of the Gastroenterology Division at Akita City Hospital in Japan. ac060950@akita-city-hp.jp.
4
Gastroenterologist at Akita City Hospital in Japan. satokotsuda07@gmail.com.
5
Gastroenterologist at Akita City Hospital in Japan. acd00377@akita-city-hp.jp.
6
Gastroenterologist at Akita City Hospital in Japan. ac120502@akita-city-hp.jp.
7
Gastroenterologist at Akita City Hospital in Japan. nabeken_9989@yahoo.co.jp.
8
Gastroenterologist at Akita City Hospital in Japan. pixmon1231@gmail.com.
9
Gastroenterologist and the Director of Akita City Hospital, in Japan. ac990892@akita-city-hp.jp.
10
Gastroenterologist at Nakadori General Hospital in Japan. nrp05157@nifty.com.

Abstract

BACKGROUND:

Approximately 30% of patients with Crohn disease (CD) are unresponsive to biologics. No previous study has focused on a plant-based diet in an induction phase of CD treatment.

OBJECTIVE:

To investigate the remission rate of infliximab combined with a plant-based diet as first-line (IPF) therapy for CD.

METHODS:

This was a prospective single-group trial conducted at tertiary hospitals. Subjects included consecutive adults with a new diagnosis (n = 26), children with a new diagnosis (n = 11), and relapsing adults (n = 9) with CD who were naïve to treatment with biologics. Patients were admitted and administered a standard induction therapy with infliximab (5 mg/kg; 3 infusions at 0, 2, and 6 weeks). Additionally, they received a lacto-ovo-semivegetarian diet. The primary end point was remission, defined as the disappearance of active CD symptoms at week 6. Secondary end points were Crohn Disease Activity Index (CDAI) score, C-reactive protein (CRP) concentration, and mucosal healing.

RESULTS:

Two adults with a new diagnosis were withdrawn from the treatment protocol because of intestinal obstruction. The remission rates by the intention-to-treat and per-protocol analyses were 96% (44/46) and 100% (44/44), respectively. Mean CDAI score (314) on admission decreased to 63 at week 6 (p < 0.0001). Mean CRP level on admission (5.3 mg/dL) decreased to 0.2 (p < 0.0001). Mucosal healing was achieved in 46% (19/41) of cases.

CONCLUSION:

IPF therapy can induce remission in most patients with CD who are naïve to biologics regardless of age or whether they have a new diagnosis or relapse.

PMID:
29035182
PMCID:
PMC5638637
DOI:
10.7812/TPP/17-009
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center