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Exclusive enteral nutrition (EEN) is recommended by the European and North American Societies for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN, NASPGHAN) as first line remission induction in paediatric Crohn’s disease. Remission is induced in up to 80%. 1 Advantages include provision of a nutritionally complete feed and minimal side effects compared to corticosteroids.2 Proposed mechanisms include effect on intestinal immune function, direct anti-inflammatory effects and induction of microbiome changes.1–3 Whole protein feed is recommended, literature is limited on individual products.We aimed to evaluate remission rates and outcomes of Ensure Plus/Paediasure Plus as EEN in our tertiary centre.Patients receiving EEN for induction of remission (first occurrence) were identified from the departmental database. Data collected included demographics, disease characteristics, admission route, refeeding risk, days to target volume, prolonged stay, completion and remission rates, further induction and maintenance treatment, ongoing supplementation.50 patients were identified over a 12-month period. Mean age at diagnosis was 11.58 years. Disease distribution: 2/50 ileal, 15/50 ileocolonic, 17/50 upper gastrointestinal (UGI) + ileocolonic, 4/50 colonic + UGI, 12/50 colonic only. Further subtyping included 35/50 luminal, 12/50 fistulating, 1/50 fistulating + stricturing, 2/50 stricturing, 13/50 perianal.Percentage median BMI (%mBMI) was >80 in 37/50, 70–80 in 7/50, <70 in 2/50. All with%mBMI <80 had ileal or UGI disease. 19/50 were high refeeding risk, based on%mBMI, oral intake, weight loss.41/50 used Ensure Plus, 8/50 Paediasure Plus, 1/50 EO28 (milk allergy).37/50 completed orally, 11/50 via nasogastric tube (NGT), 2/50 combination. 49/50 were admitted to commence EEN, 1/50 did home EEN. 23/49 were admitted from theatre, 15/49 electively, 3/49 via Emergency Department (ED), 6/49 transferred from a district general hospital (DGH).Modal days to target volume was 3 (range 2 – 9). Modal length of stay was 4 days (range 2 – 42). 19/49 had a prolonged stay: 11/49 nutritional rehabilitation prior to endoscopy, 4/49 NGT training, 1/49 to meet target, 3/49 for other management.9/49 required oral phosphate replacement during EEN, 1/49 required oral magnesium. No patients required IV replacement. 9/10 (90%) requiring electrolyte replacement were identified as high refeeding risk.38/50 (76%) completed EEN. Reasons for discontinuation included: no improvement at 4 weeks (7/50), vomiting (2/50), erythema nodosum (2/50), patient choice (1/50). 12/50 (24%) continue on nutritional supplements.22/50 were excluded from further analysis (top-down treatment 9/22; early cessation 12/22, alternative feed 1/22).28/50 were analysed further. 26/28 demonstrated weight gain. 26/28 were in clinical remission at 8 weeks, 24/28 at 3 months, 19/28 at 6 months, 15/20 at 12 months. 3/28 required steroids, 2/28 second EEN course, 2/28 steroids and EEN. 3/28 later commenced biologics.Ensure/Paediasure Plus is well tolerated and effective. Most complete EEN orally with average 3 days to target volume. Remission rates are high at EEN completion and 3 months (93%, 86%). 68% and 75% respectively sustained remission at 6 and 12 months. A minority required further EEN or steroid courses or later biologic therapy. None required IV electrolyte replacement regardless of initial refeeding risk category. Home EEN may be safe and effective.References Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, Amil Dias J, Barabino A, Braegger CP, Bronsky J, Buderus S, Martín-de-Carpi J, De Ridder L, Fagerberg UL, Hugot JP, Kierkus J, Kolacek S, Koletzko S, Lionetti P, Miele E, Navas López VM, Paerregaard A, Russell RK, Serban DE, Shaoul R, Van Rheenen P, Veereman G, Weiss B, Wilson D, Dignass A, Eliakim A, Winter H, Turner D. European Crohn’s and Colitis Organisation; European Society of Pediatric Gastroenterology, Hepatology and Nutrition. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis. 2014 Oct;8(10):1179–207. doi: 10.1016/j.crohns.2014.04.005. Epub 2014 Jun 6. PMID: 24909831.van Rheenen PF, et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. Journal of Crohn’s and Colitis Feb 2021;15(2):171–194. https://doi.org/10.1093/ecco-jcc/jjaa161 Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):298–305. doi: 10.1097/MPG.0b013e318235b397. Erratum in: J Pediatr Gastroenterol Nutr. 2012 Apr;54(4):573. PMID: 22002478.