PW26 - SEMI-ELEMENTAL VERSUS POLYMERIC FORMULA FOR EXCLUSIVE ENTERAL NUTRITION IN THE PREOPERATIVE OPTIMIZATION FOR PATIENTS WITH CROHN`S DISEASE: A MULTICENTER RANDOMIZED CONTROLLED TRIAL (SEPEN-CD)
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PW26
SEMI-ELEMENTAL VERSUS POLYMERIC FORMULA FOR EXCLUSIVE ENTERAL NUTRITION IN THE PREOPERATIVE OPTIMIZATION FOR PATIENTS WITH CROHN`S DISEASE: A MULTICENTER RANDOMIZED CONTROLLED TRIAL (SEPEN-CD)
X. Ge1,2, W. Zhou1,2,*
1Zhejiang University, 2Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
Rationale: Exclusive enteral nutrition (EEN) is reported to play an important role in the preoperative optimization strategy for Crohn`s disease (CD) patients. According to the nitrogen source, enteral nutrition can be categorized into semi-elemental and polymeric formula. The aim of the study was to compare the efficacy and the tolerance of a semi-elemental versus a polymeric formula in the preoperative optimization for CD patients.
Methods: A multicenter randomised controlled trial was performed across five hospitals in China between 2023 and 2025. Enrolled participants were randomized in an allocation ratio of 1:1 to receive either semi-elemental based enteral nutrition or polymeric based enteral nutrition. The polymeric based enteral nutrition group received an intact-protein formula [enteral nutritional suspension (TPF) ®: 500ml, 1 kcal/ml, 20 g/500 mL of protein (Nutricia, Wuxi, China)]. The semi-elemental group received Peptison liquid with a short-peptide formula [enteral nutritional suspension (SP) ®: 500ml, 1 kcal/ml, 20 g/500 mL of protein (Nutricia, Wuxi, China)]. The duration of EEN was 6 weeks. The primary endpoint was the percentage of change in the C-reactive protein (CRP) to albumin (ALB) ratio (CAR).
Results: Totally, 304 patients were randomly assigned with 152 in polymeric group and 152 in semi-elemental group. The percentage of change in the CAR (90.3% vs. 78.7%, P=0.001) was significantly higher in the semi-elemental group than that in the polymeric group. In subgroup analysis, patients with penetrating phenotypes had significantly higher percentage of change in the CAR in the semi-elemental group than in the polymeric group (90.3% vs. 78.2%, P=0.008), however, the primary endpoint did not differ significantly between groups with stricturing phenotypes (90.4% vs. 90.8%, P=0.874).
Conclusion: Semi-elemental formula appears to have beneficial impact on modulating inflammatory status and improving nutritional status in CD compared to polymeric formula.
Disclosure of Interest: None declared