High body mass index is associated with increased risk of treatment failure and surgery in biologic‐treated patients with ulcerative colitis

• DOI: 10.1111/apt.14665
• Publication Date: 2018-04-17T19:12:45Z
• Authors: S. Kurnool; N. H. Nguyen; J. Proudfoot; P. S. Dulai; B. S. Boland; N. Vande Casteele; E. Evans; E. L. Grunvald; A. Zarrinpar; W. J. Sandborn; S. Singh
• Keywords: Adult; Male; Clinical Sciences; Clinical Trials and Supportive Activities; 610; Ulcerative; Clinical sciences; Antibodies, Monoclonal, Humanized; Autoimmune Disease; Oral and gastrointestinal; Antibodies; Body Mass Index; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Risk Factors; 616; Monoclonal; Humans; Obesity; Treatment Failure; Humanized; Nutrition; Retrospective Studies; 2. Zero hunger; Biological Products; Biomedical and Clinical Sciences; Gastroenterology & Hepatology; Tumor Necrosis Factor-alpha; Prevention; Inflammatory Bowel Disease; Adalimumab; Evaluation of treatments and therapeutic interventions; Pharmacology and Pharmaceutical Sciences; Middle Aged; Colitis; Infliximab; 3. Good health; Biological Therapy; Hospitalization; Pharmacology and pharmaceutical sciences; 6.1 Pharmaceuticals; Colitis, Ulcerative; Female; Patient Safety; Digestive Diseases

Summary Background Though pharmacokinetic studies suggest accelerated biologic drug clearance with increasing body weight, evidence of obesity's impact on clinical outcomes in biologic‐treated patients ulcerative colitis ( UC ) is inconsistent. Aim To evaluate the obesity real world response to biological therapy . Methods In a single‐centre retrospective cohort study between 2011‐2016 , we evaluated treatment by baseline mass index BMI ). Primary outcome was failure (composite IBD ‐related surgery/hospitalisation or modification including dose escalation, discontinuation addition corticosteroids); secondary were risk and endoscopic remission. We conducted multivariate Cox proportional hazard analyses independent outcomes. Stratified analysis weight‐based regimens (infliximab) fixed‐dose (adalimumab, golimumab, vedolizumab, certolizumab pegol) performed. Results included 160 (50% males, 55% infliximab) median IQR age 36 y (26‐52) 24.3 kg/m 2 (21.4‐28.7). On analysis, each 1 increase associated 4% (adjusted ratio [ aHR ], 1.04 [95% CI 1.00‐1.08]) 8% 1.08 [1.02‐1.14]). The effect seen dosing therapies. Conclusion independently increased regimen.