Current perspectives and future horizons in predicting response to nutrition therapy in children with Crohn's disease - a narrative review.

Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) alongside Crohn's Disease Exclusion Diet (CDED) are evidence-based treatment strategies for children with Crohn's disease. However, the remission rates induced through nutritional therapy vary depending on the research design, treatment population, and outcome definition. The growing body of evidence highlights the necessity of a transitioning from "one-treatment-suits-all" strategy towards "tailor-made" precision-based therapeutic approach in children with Crohn's disease to obtain the optimal treatment response. Precise personalized therapeutic plan created on the patient's treatment-responsiveness phenotype prior to the treatment initiation appears to be an utmost need for children with Crohn's disease. A personalized approach to treatment has multiple benefits for individuals and the healthcare system. The identification of reliable predictors of treatment response is crucial for selecting the optimal therapy for individuals. In this review we aim to present a state-of-the-art summary of the current knowledge on predictive factors of response to nutrition therapy defined as EEN, and PEN with CDED in children with Crohn's disease. The exploration of treatment predictors may be a small but crucial step toward individualized therapeutic approach in this group of patients, potentially enabling the selection of the most appropriate therapy for each individual patient. IMPACT: This review synthetizes the current knowledge on predictive factors of a response to nutrition therapy in children with Crohn's disease. Early clinical improvement and reduction of faecal calprotectin are potential indicators of positive outcome of nutritional therapy in Crohn's disease. The anticipation of treatment response transcends patients' stratification based on clinical characteristics assemblages. Integration of clinical and multiomic data into a decision-making approach may facilitate personalized treatment in the future. However, current literature provides insufficient evidence for definitive predictors of response to nutritional therapy in Crohn's disease.