Combining thiopurine with partial enteral nutrition promotes complete mucosal healing in pediatric Crohn's disease

Abstract Background The combination of thiopurines and partial enteral nutrition (TP/PEN) is a common maintenance therapy for mild‐to‐moderate Crohn's disease (CD) in pediatric patients. However, no studies have investigated the efficacy of TP/PEN. This study aimed to evaluate the non‐relapse and complete mucosal healing rates in pediatric CD patients following treatment with or without TP, in addition to PEN. Methods This retrospective observational study included 39 pediatric patients diagnosed with mild‐to‐moderate CD. Based on the proposed treatment, the patients were divided into the TP/PEN and PEN‐only groups. The primary outcome was the relapse‐free rate between the two groups. Relapse was defined as a pediatric Crohn's disease activity index (PCDAI) >12.5, Simple Endoscopic Score‐CD (SES‐CD) score >7, Lewis score > 135, and/or abnormal C‐reactive protein levels (CRP > 0.15 mg/dL). The secondary outcome was complete mucosal healing (SES‐CD score 0) at 12–24 months. Results Although the difference in non‐relapse rate between the two groups was not statistically significant, complete mucosal healing rates were significantly higher in the TP/PEN group than in the PEN‐only group. Complete mucosal healing at 12–24 months was achieved in 7/21 (33.3%) and 1/18 (5.5%) patients in the TP/PEN and PEN‐only groups, respectively ( p < 0.05). Conclusion Nowadays, more treatment options are available, and TP/PEN remains a viable option for the treatment of mild‐to‐moderate CD in pediatric patients.