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

## TL;DR

Combining thiopurines with partial enteral nutrition helps more children with Crohn's disease achieve full gut healing compared to nutrition alone.

## Contribution

This study is the first to show that thiopurines plus partial enteral nutrition improves mucosal healing in pediatric Crohn's disease.

## Key findings

- TP/PEN achieved significantly higher complete mucosal healing rates than PEN alone.
- 33.3% of TP/PEN patients achieved healing versus 5.5% in the PEN-only group.
- TP/PEN remains a viable treatment for mild-to-moderate pediatric Crohn's disease.

## Abstract

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.

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.

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).

Nowadays, more treatment options are available, and TP/PEN remains a viable option for the treatment of mild‐to‐moderate CD in pediatric patients.