A Cochrane review [Abstract] 1 included 15 studies comparing different formulations of enteral nutrition (EN) for the treatment of active Crohn's disease. 11 compared one (or more) elemental formula to a non-elemental one, three compared enteral diets of similar protein composition but different fat composition, and one compared non-elemental diets differing only in glutamine enrichment. Meta-analysis of ten trials (n=334) demonstrated no difference in the efficacy of elemental versus non-elemental formulas (OR 1.10; 95% CI 0.69 to 1.75). Subgroup analyses performed to evaluate the different types of elemental and non-elemental diets showed no statistically significant differences. Non-significant trend was demonstrated favouring very low fat and very low long chain triglyceride content, but this result should be interpreted with caution due to statistically significant heterogeneity and small sample size.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).
Primary/Secondary Keywords