E0381 - A Diet High in Fruits and Vegetables During Biologic Induction May Improve Response to Biologics in Patients With Inflammatory Bowel Disease

Andres D. Rodriguez, DO, MBA, Chunsu Jiang, MD, Yalda Zarnegarnia, , Alberto Cruz, , Oriana Damas, MD
University of Miami, Miami, FL

Introduction: Several biologics now exist as treatment for inflammatory bowel disease (IBD) but effective induction of remission still ranges between 20-40% for most. Studies suggest that diet may modify intestinal inflammation. In this study, we sought to examine the effect of diet on biochemical response to biologic induction therapies.

Methods: We conducted a single-center retrospective analysis of patients with IBD seen at a tertiary referral center from 2019 to 2021. A validated 26-item diet questionnaire, the Dietary Screener Questionnaire (DSQ), was completed as part of a pre-check-in process before each clinic visit. IBD patients who completed a DSQ within three months of induction of a biologic (anti-TNFs, vedolizumab, ustekinumab) and who had markers of inflammation available pre and post-induction (C-Reactive Protein (CRP)) were included. Follow up period was 3 months post-induction. Using linear and average mixed-effects models, we examined the contribution of food items in the DSQ (i.e., processed meats, red meats, fruits, vegetables) to a reduction in CRP following induction. We used pre-induction biochemical markers as a baseline reference. Current steroid use, prior biologic exposure, age, gender, body mass index (BMI), smoking status, IBD type (ulcerative colitis (UC) or Crohn’s disease (CD)), and class of biologic were added as covariates in the models.

Results: A total of 105 patients were included in this study (62.9% had CD and 32.4% had UC). The most common biologic was anti-TNFs (52.4%). The mean CRP value pre-induction was 13.4 (SD 20.2) and post-induction was 6.63 (SD 12.4). On multivariable analyses adjusting for covariates mentioned, we found an independent effect of high daily intake of fruits and vegetables on reduction in CRP. For every 1 unit increase in daily fruits and vegetables, there was a reduction in CRP value by 1.82 post-induction of biologics (p=0.04), Table 1. Red meat intake, processed meats, fiber from whole grains, and dairy were not associated with CRP reduction (Table 1).

Discussion: In this preliminary analysis, we find that a diet high in fruits and vegetables during induction of biologics may independently improve biochemical response. Future clinical drug trials should consider dietary assessment and the influence of diet on response to medication treatment.



Disclosures:


Andres D. Rodriguez, DO, MBA, Chunsu Jiang, MD, Yalda Zarnegarnia, , Alberto Cruz, , Oriana Damas, MD. E0381 - A Diet High in Fruits and Vegetables During Biologic Induction May Improve Response to Biologics in Patients With Inflammatory Bowel Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.