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        Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease

        ( Sanchit Sharma ),( Arti Gupta ),( Saurabh Kedia ),( Samagra Agarwal ),( Namrata Singh ),( Sandeep Goyal ),( Saransh Jain ),( Vipin Gupta ),( Pabitra Sahu ),( Sudheer Kumar Vuyyuru ),( Bhaskar Kante 대한장연구학회 2021 Intestinal Research Vol.19 No.3

        Background/Aims: Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods: This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI >70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results: Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2-6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260-320] vs. 240 [180-280], P=0.001) and 8 weeks (baseline 290 [260-320] vs. 186 [160-240], P=0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n=4), B2 (n=18), and B3 (n=9) phenotypes were 50%, 78.8%, and 100% respectively (log-rank test, P=0.093). The response rates at 8 weeks with polymeric (n=8) and semi-elemental diet (n=23) were 75% and 82.6% respectively (log-rank test, P=0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002-1.017; P=0.046) predicted response to EEN. Conclusions: EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN. (Intest Res 2021;19:291-300)

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        Novel time and site specific ‘‘tablets in capsule’’ system for nocturnal asthma treatment

        Sonia Pandey,Preety Mehta,Hetal Patel,Ritesh Shah,Arti Gupta,Ashish Mishra 한국약제학회 2014 Journal of Pharmaceutical Investigation Vol.44 No.5

        The objective of present work was to develop a‘‘tablets in capsule’’ system for facilitating both immediateand pulsatile drug deliveries of theophylline to mimic thecircadian rhythm of nocturnal asthma. The system comprisedof capsule filled with two tablets, first pulse andsecond pulse tablet prepared by wet granulation method. First pulse tablet was not coated and was responsible forproviding loading dose whereas; second pulse tablet wascoated with Eudragit L100 and Eudragit S100 to releasedrug in colon after specific lag time. Two independentvariables, amount of polymers and coating thickness, wereoptimized by 32 full factorial design. The optimum formulationconsisted of Eudragit L100: Eudragit S100 in1:1.5 ratio and coating thickness of 20 % (w/w). In vitrodrug release of ‘‘tablets in capsule’’ system in three differentmedia (pH 1.2, pH 6.8, and pH 7.4) revealedimmediate and pulsatile release patterns.

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