Effect of Overweight and Obesity on the Response to Anti-Tnf Therapy and Disease Course in Children With Ibd Publisher Pubmed



Sila S¹ ; Aloi M² ; Cucinotta U³ ; Gianolio L⁴ ; Granot M⁵ ; Hradsky O⁶ ; Hussey S⁷ ; Kang B⁸ ; Karoliny A⁹ ; Kolho KL¹⁰ ; De Laffolie J¹¹ ; Lega S¹² ; Matar M¹³ ; Norsa L^{14, 15} Show All Authors
Source: Inflammatory Bowel Diseases Published:2025

Abstract

Background: This study aimed to evaluate the effect of overweight and obesity at the start of anti-TNF therapy on treatment response and relapse rate in children with inflammatory bowel disease (IBD). Methods: This multicenter, retrospective cohort study included 22 IBD centers in 14 countries. Children diagnosed with IBD in whom antitumor necrosis factor (anti-TNF) was introduced were included; those who were overweight/ obese were compared with children who were well/ undernourished. Results: Six hundred thirty-seven children (370 [58%] males; mean age 11.5 ± 3.5 years) were included; 140 (22%) were in the overweight/obese group (OG) and 497 (78%) had BMI ≤1 SD (CG). The mean follow-up time was 141 ± 78 weeks (median 117 weeks). There was no difference in the loss of response (LOR) to anti-TNF between groups throughout the follow-up. However, children in OG had more dose escalations than controls. Male sex and lack of concomitant immunomodulators at the start of anti-TNF were risk factors associated with the LOR. There was no difference in the relapse rate in the first year after anti-TNF introduction; however, at the end of the follow-up, the relapse rate was significantly higher in the OG compared with CG (89 [64%] vs 218 [44%], respectively, P < .001). Univariate and multivariate analysis revealed that being overweight/obese, having UC, or being of male sex were factors associated with a higher risk for relapse. Conclusions: Overweight/obese children with IBD were not at a higher risk of LOR to anti-TNF. Relapse in the first year after anti-TNF was introduced, but risk for relapse was increased at the end of follow-up. © The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved.