Patient acceptability of partial enteral nutrition as a concomitant therapy to Adalimumab in adults with active Crohn's disease - BIOPIC trial.

INTRODUCTION: Partial enteral nutrition (PEN) is a dietary therapy for the management of Crohn's disease (CD). Although considered less restrictive than exclusive enteral nutrition, there is scarce data from patients with lived experience to support PEN. This study assessed dietary intake, the acceptability and adherence to 50% PEN alongside treatment with adalimumab, for six-weeks, in adults with active CD. METHODS: Adherence to PEN was measured by three methods: an interview with a dietitian using an adherence questionnaire, dietary analysis from food diaries, and inventory from provided enteral nutrition formula and unused stock returned. Food diaries were also used to assess differences in intake between participants receiving 50% PEN (ADA+PEN group) and those who did not (ADA group). RESULTS: Twenty-nine of 41 patients (71%) took the PEN volume prescribed every-day for six-weeks; 39 (95%) met the full PEN volume prescribed for five-weeks or more. Fifty-nine percent reported no issues adhering to PEN, 11.5% felt too full, 10.5% reported social life constraints and 5% taste fatigue. Most respondents would use PEN again to manage CD (93%). Food-diary analysis also showed high level of adherence [median (IQR) daily energy intake provided by PEN: 53% (49;71.2)]. The median (IQR) percentage of enteral feed used from the volume provided was 96% (88;101). Participants in the ADA+PEN group modified the unrestricted portion of their diet, particularly dinners. CONCLUSION: These results support the good acceptability rate of 50% PEN alongside treatment with Adalimumab, emphasising its potential of being a viable dietary treatment option for adults with CD.