The body composition profile is associated with response to anti‐<scp>TNF</scp> therapy in Crohn's disease and may offer an alternative dosing paradigm

Ding, Nik Sheng; Malietzis, George; Lung, P; Penez, L; Yip, Wai Man; Gabe, Simon; Jenkins, John T.; Hart, Ailsa

doi:10.1111/apt.14293

Cited by 60 publications

(59 citation statements)

References 39 publications

(53 reference statements)

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Section: Discussionmentioning

confidence: 77%

“…Our findings build upon an evolving and conflicting body of evidence on the potential negative impact of obesity in patients with IBD, in particular its impact on treatment response to biologics. [18][19][20] While obesity has been consistently shown to negatively impact treatment response to anti-TNF agents in rheumatic diseases, this evidence has been inconsistent in patients with IBD. In a meta-analysis of 16 studies with 3130 patients with IBD, we observed that obesity does not significantly influence treatment response to anti-TNF agents (odds of failing therapy, 1.20; 95% CI, 0.88-1.64).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Kurnool

Nguyen

Proudfoot

et al. 2018

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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

Kurnool

Nguyen

Proudfoot

et al. 2018

Aliment Pharmacol Ther

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“…FC, as a measure of luminal inflammation in IBD, was negatively associated with ASMI, which is consistent with the known catabolic effects of chronic inflammation [ 18 , 20 , 47 ]. Lean mass is important in patients with IBD, and has been shown to have a bearing on response to therapy, surgical outcomes, and quality of life [ 15 , 18 , 20 , 48 , 49 ]. Grip strength proved to be a simple anthropometric test that was independently and positively associated with ASMI, while also negatively associated with FMI.…”

Section: Discussionmentioning

confidence: 99%

Obesity in Inflammatory Bowel Disease: Gains in Adiposity despite High Prevalence of Myopenia and Osteopenia

et al. 2018

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Background: Rising rates of obesity have been reported in patients with inflammatory bowel disease (IBD); however, prospective data is lacking. The aim of this study is to prospectively evaluate body composition in adults with IBD over 24 months. Methods: Whole body dual energy X-ray absorptiometry (DXA) data was performed at 0 months, 12 months, and 24 months. Bone mineral density (BMD), fat mass index (FMI (kg)/height (m2)), appendicular skeletal muscle index (ASMI (kg)/height (m2)), visceral adipose tissue and the visceral adipose height index (VHI, VAT area (cm3)/height (m2)), and clinical and anthropometric assessments were performed at each time point. Multivariable linear mixed effects regression analyses were performed. Results: Initially, 154 participants were assessed at baseline (70% Crohn’s disease, 55% male, median age 31 years), of whom 129 underwent repeated DXA at 12 months, and 110 underwent repeated DXA at 24 months. Amongst those undergoing repeated DXA, their body mass index (BMI) significantly increased over time, such that by 24 months, 62% of patients were overweight or obese (annual change BMI β = 0.43, 95%CI = [0.18, 0.67], p = 0.0006). Gains in BMI related to increases in both FMI and VHI (β = 0.33, 95%CI = [0.14, 0.53], p = 0.0007; β = 0.08, 95%CI = [0.02, 0.13], p = 0.001; respectively), whereas ASMI decreased (β = −0.07, 95%CI = [−0.12, −0.01], p = 0.01) with a concordant rise in rates of myopenia (OR = 3.1 95%CI = [1.2, 7.7]; p = 0.01). Rates of osteopenia and osteoporosis were high (37%), but remained unchanged over time (p = 0.23). Conclusion: Increasing rates of obesity in patients with IBD coincide with decreases in lean muscle mass over time, while high rates of osteopenia remain stable. These previously undocumented issues warrant attention in routine care to prevent avoidable morbidity.

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“…Ding et al have hypothesised in AP&T that body composition can indeed predict the outcome of anti‐TNF therapy . There are several reasons why this may be the case.…”

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confidence: 99%

Editorial: anti‐TNF therapy and myopenia in Crohn's disease—another step towards personalised medicine

Murray

2017

Aliment Pharmacol Ther

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The body composition profile is associated with response to anti‐TNF therapy in Crohn's disease and may offer an alternative dosing paradigm

Abstract: In this cohort study, body composition profiles did not correlate well with BMI. Myopenia was associated with primary nonresponse with potential implications for dosing and serves as an explanation for pharmacokinetic failure.

Cited by 60 publications

References 39 publications

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

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

Obesity in Inflammatory Bowel Disease: Gains in Adiposity despite High Prevalence of Myopenia and Osteopenia

Editorial: anti‐TNF therapy and myopenia in Crohn's disease—another step towards personalised medicine

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