Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial.
Study Goal
The researchers aimed to determine the remission rate of infliximab combined with a plant-based diet as first-line therapy for Crohn disease (CD).
Results Summary
The study found high remission rates (96% intention-to-treat, 100% per-protocol), significant reductions in CDAI scores and CRP levels, and mucosal healing in 46% of cases. The combination therapy was effective in inducing remission in most patients.
Population
Adults and children with newly diagnosed or relapsing CD who were naïve to biologics.
Effective Dosage
Infliximab (5 mg/kg at 0, 2, and 6 weeks) plus a lacto-ovo-semivegetarian diet.
Duration
6 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
infliximab combined with a plant-based diet as first-line (IPF) therapy | increase | remission | patients with CD who are naïve to biologics regardless of age or whether they have a new diagnosis or relapse | - | can induce remission | #1 |
infliximab combined with a plant-based diet as first-line (IPF) therapy | increase | remission | adults with a new diagnosis, children with a new diagnosis, and relapsing adults with CD who were naïve to treatment with biologics | 96% (44/46) | remission rates | #2 |
infliximab combined with a plant-based diet as first-line (IPF) therapy | increase | remission | adults with a new diagnosis, children with a new diagnosis, and relapsing adults with CD who were naïve to treatment with biologics | 100% (44/44) | remission rates | #3 |
infliximab combined with a plant-based diet as first-line (IPF) therapy | decrease | Crohn Disease Activity Index (CDAI) score | adults with a new diagnosis, children with a new diagnosis, and relapsing adults with CD who were naïve to treatment with biologics | from 314 to 63 at week 6 | decreased | #4 |
infliximab combined with a plant-based diet as first-line (IPF) therapy | decrease | C-reactive protein (CRP) concentration | adults with a new diagnosis, children with a new diagnosis, and relapsing adults with CD who were naïve to treatment with biologics | from 5.3 mg/dL to 0.2 | decreased | #5 |
infliximab combined with a plant-based diet as first-line (IPF) therapy | increase | mucosal healing | adults with a new diagnosis, children with a new diagnosis, and relapsing adults with CD who were naïve to treatment with biologics | 46% (19/41) | was achieved | #6 |
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.