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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 L14, 15 Show All Authors
Authors
  1. Sila S1
  2. Aloi M2
  3. Cucinotta U3
  4. Gianolio L4
  5. Granot M5
  6. Hradsky O6
  7. Hussey S7
  8. Kang B8
  9. Karoliny A9
  10. Kolho KL10
  11. De Laffolie J11
  12. Lega S12
  13. Matar M13
  14. Norsa L14, 15
  15. Omiwole S7
  16. Orlanskimeyer E16
  17. Palomino L17
  18. Rohani P18
  19. Scarallo L19
  20. Sladek M20
  21. Sohouli MH18
  22. Urlep D21
  23. Yerushalmyfeler A22
  24. Zifman E23
  25. Hojsak I1
Show Affiliations
Authors Affiliations
  1. 1. Children’s Hospital Zagreb, University of Zagreb Medical School, Zagreb, Croatia
  2. 2. Pediatric Gastroenterology Unit, Sapienza University–Umberto I Hospital, Rome, Italy
  3. 3. Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood, University of Messina, Italy
  4. 4. Department of Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
  5. 5. Pediatric Gastroenterology and Nutrition Unit, Sheba Medical Center, The Faculty of Medicine, Tel Aviv University, Tel-HaShomer, Tel Aviv, Israel
  6. 6. Department of Paediatrics, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
  7. 7. DOCHAS Group, Children’s Health Ireland, University College Dublin, Dublin, Ireland
  8. 8. Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea
  9. 9. Heim Pal National Pediatric Institute, Budapest, Hungary
  10. 10. University of Helsinki, HUS, Children´s Hospital, Helsinki, Finland
  11. 11. Justus-Liebig-University Giessen, Childrens Hospital, Giessen, Germany
  12. 12. Institute for Maternal and Child Health, IRCCS “Burlo Garofolo, ”, Trieste, Italy
  13. 13. Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Petach-Tikva, Tel Aviv, Israel
  14. 14. Pediatric Hepatology, Gastroenterology and Transplantation Department, ASST Papa Giovanni XXIII, Bergamo, Italy
  15. 15. Pediatric Department, Children’s Hospital Vittore Buzzi, University of Milan, Milan, Italy
  16. 16. Juliet Keidan Institute of Pediatric Gastroenterology, Hepatology, and Nutrition, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
  17. 17. Gastroenterology and Nutrition Unit, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
  18. 18. Pediatric Gastroenterology and Hepatology Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  19. 19. Gastroenterology and Nutrition Unit, Meyer Children Hospital IRCCS, Florence, Italy
  20. 20. Department of Pediatrics, Gastroenterology and Nutrition Jagiellonian University Medical College, Krakow, Poland
  21. 21. Pediatric Gastroenterology and Liver Unit, University Children’s Hospital of the University Medical Centre Ljubljana, Ljubljana, Slovenia
  22. 22. Pediatric Gastroenterology Institute, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  23. 23. Pediatric gastroenterology clinic, Meir Medical Center, School of Medicine, Tel-Aviv University, Kfar Saba, Tel Aviv, Israel

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.
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