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. 2025 Jun 18:12:1591954.
doi: 10.3389/fnut.2025.1591954. eCollection 2025.

The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn's disease: a cohort study

Chen Huang #  1 , Chao Chen #  1 , Hao Wu  1 , Hanyu Yin  1 , Weixiang Yao  1 , Susu Bai  2 , Baixue Zhuo  3 , Xiaoli Wu  1
Affiliations

The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn's disease: a cohort study

Chen Huang et al. Front Nutr. .

Abstract

Background and aims: The issue of loss of efficacy with infliximab (IFX) treatment in Crohn's disease (CD) significantly limits its clinical use. This study aims to investigate the role of therapy combined with partial enteral nutrition (PEN) in maintaining the efficacy of infliximab.

Methods: Consecutive CD patients undergoing IFX for induction and maintenance therapy were included, with a follow-up period of at least 54 weeks and endoscopy performed around 54 weeks. Subsequent longitudinal monitoring evaluated improvements in the Crohn's Disease Activity Index (CDAI) score at 14 weeks and endoscopic remission at 54 weeks.

Results: Among the 176 included patients, 99 (56%) were in the IFX monotherapy group, and 77 (44%) were in the IFX + PEN group. A significantly higher proportion of patients in the IFX + PEN group achieved clinical response (defined as a CDAI decrease ≥70 points) compared to those in the IFX group at 14 weeks (87.01% vs. 74.75%, p = 0.043), as well as a higher proportion achieving endoscopic remission at 54 weeks (84.42% vs. 65.66%, p = 0.005). Meanwhile, combination therapy with PEN emerged as an independent protective predictor of endoscopic remission at 54 weeks in two multivariate-adjusted models, with ORs of 3.34 and 3.33, respectively (both p < 0.05). Subgroup analysis and interaction test results further supported that all CD patients can benefit from combination therapy with PEN.

Conclusion: Infliximab treatment combined with partial enteral nutrition is beneficial for both short-term clinical response and long-term endoscopic remission in CD patients.

Keywords: Crohn’s disease; clinical response; endoscopic remission; infliximab; partial enteral nutrition; safety.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Efficacy between the IFX + PEN group and IFX monotherapy group. (A) CDAI scores at baseline and at week 14 in two groups. (B) CDAI score change during 14-week period in two groups. (C) The number and partition of CD patients achieving clinical response at week 14. (D) The number and partition of CD patients achieving clinical remission at week 14. (E) The number and partition of CD patients achieving endoscopic remission at week 54.
Figure 2
Figure 2
The protective role of treatment combined partial enteral nutrition in achieving endoscopic remission in patients with Crohn’s disease.
See this image and copyright information in PMC

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