Epidemiology and Risk Factors for Hospitalization in Patients with Ulcerative Colitis and Crohn’s Disease

Dalal, Robin; Schwartz, David

doi:10.1007/978-1-0716-1987-2_1

Cited by 1 publication

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“…In this large, multicenter, EHR-based cohort study of more than 3,000 patients with IBD starting new biologic therapy, of whom 14% were obese, we found obesity was not associated with risk of hospitalization, IBD-related surgery, or serious infections after adjusting for confounding factors within 1 year of initiating biologic therapy. We also confirmed previously observed risk factors independent from obesity for adverse treatment outcomes and serious infections with biologic therapy, including high burden of comorbidities, concomitant corticosteroid and opiate use, elevated CRP at baseline, and previous hospitalization (17,27). Our findings suggest obesity does not significantly affect unplanned healthcare utilization and treatment-related complications in patients with IBD starting new biologic therapy.…”

Section: Discussionsupporting

confidence: 89%

Effect of Obesity on Risk of Hospitalization, Surgery, and Serious Infection in Biologic-Treated Patients With Inflammatory Bowel Diseases: A CA-IBD Cohort Study

Luo

Kim

et al. 2022

Am J Gastroenterol

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INTRODUCTION: Obesity is variably associated with treatment response in biologic-treated patients with inflammatory bowel diseases (IBD). We evaluated the association between obesity and risk of hospitalization, surgery, or serious infections in patients with IBD in new users of biologic agents in a large, multicenter, electronic health record (EHR)-based cohort (CA-IBD). METHODS:We created an EHR-based cohort of adult patients with IBD who were new users of biologic agents (tumor necrosis factor [TNF-a] antagonists, ustekinumab, and vedolizumab) between January 1, 2010, and June 30, 2017, from 5 health systems in California. Patients were classified as those with normal body mass index (BMI), overweight, or obese based on the World Health Organization classification. We compared the risk of all-cause hospitalization, IBD-related surgery, or serious infections among patients with obesity vs those overweight vs those with normal BMI, using Cox proportional hazard analyses, adjusting for baseline demographic, disease, and treatment characteristics. RESULTS:Of 3,038 biologic-treated patients with IBD (69% with Crohn's disease and 76% on TNF-a antagonists), 28.2% (n 5 858) were overweight, and 13.7% (n 5 416) were obese. On a follow-up after biologic initiation, obesity was not associated with an increased risk of hospitalization (adjusted hazard ratio [aHR] vs normal BMI, 0.90; [95% confidence interval, 0.72-1.13]); IBD-related surgery (aHR, 0.62 [0.31-1.22]); or serious infection (aHR,). Similar results were observed on stratified analysis by disease phenotype (Crohn's disease vs ulcerative colitis) and index biologic therapy (TNF-a antagonists vs non-TNF-a antagonists).

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Section: Discussionsupporting

confidence: 89%