Low muscle mass at initiation of anti-TNF therapy for inflammatory bowel disease is associated with early treatment failure: a retrospective analysis

Holt, Darcy; Varma, Poornima; Strauss, Boyd Josef Gimnicher; Rajadurai, Anton; Moore, Gregory Thomas Charles

doi:10.1038/ejcn.2017.10

Cited by 39 publications

(40 citation statements)

References 39 publications

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“…These findings are similar to adult studies where sarcopenia prevalence in the pre‐LTx and post‐LTx periods has been reported to range 30%–70% . Sarcopenia prevalence was highest in female children <10 years, a finding that has been reported in other studies where significant lean body mass deficits have been reported in younger female children with newly diagnosed and longer term Crohn's disease . Although linear growth and weight gain were within normal reference ranges in the majority of children, sarcopenia was associated with reduced linear growth and weight gain when compared with children without sarcopenia.…”

Section: Discussionsupporting

confidence: 88%

“…11,12,[30][31][32][33] Sarcopenia prevalence was highest in female children <10 years, a finding that has been reported in other studies where significant lean body mass deficits have been reported in younger female children with newly diagnosed and longer term Crohn's disease. 18,34,35 Although linear growth and weight gain were within normal reference ranges in the majority of children, sarcopenia was associated with reduced linear growth and weight gain when compared with children without sarcopenia. This was particularly evident in the first year post-LTx where catch-up linear growth was not observed in the children with sarcopenia.…”

Section: Discussionmentioning

confidence: 93%

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Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions

Mager

Hager

Ooi

et al. 2018

J Parenter Enteral Nutr

129

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions

Mager

Hager

Ooi

et al. 2018

J Parenter Enteral Nutr

129

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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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“…Recent research indicates that an increased rate of major postoperative complications is correlated with IBD-induced myopenia, including mortality and morbidity (14,15). In addition, low LM at the initiation of anti-TNF treatment is also indicative of higher nonresponse rates (16). Although these relations may be heightened due to the severity of disease at time of surgery or initiation of biologics, the impact of LM on both current and future disease outcomes is critical.…”

Section: Lean Body Mass In Pediatric Inflammatory Bowel Diseasementioning

confidence: 99%

Conceptual Model of Lean Body Mass in Pediatric Inflammatory Bowel Disease

Barnes

Lynch

Lisenby

et al. 2019

J. pediatr. gastroenterol. nutr.

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Youth with inflammatory bowel disease (IBD) demonstrate deficits in lean mass (LM) placing them at increased risk for future health problems, including reduction of bone mass and impaired bone architecture. Research suggests that deficits in LM are multifactorial, including influences from the disease and its treatment, and health behaviors such as diet and physical activity. Based on a systematic literature review examining factors related to LM deficits in IBD, this article presents a conceptual model to explain the development of LM in youth with IBD. The model considers predictors of LM across 4 domains: demographic; medical; diet; and physical activity. Much existing research is cross-sectional, but suggests multiple factors work together to promote or inhibit LM accrual in youth with IBD. The conceptual model, developed based on empirical findings to date, can be used to understand and further elucidate the process through which LM is developed and maintained, to inform the development of empirically supported clinical interventions, and to guide future research objectives and priorities.

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Low muscle mass at initiation of anti-TNF therapy for inflammatory bowel disease is associated with early treatment failure: a retrospective analysis

Abstract: Identifying low muscle mass at anti-TNF induction as a risk factor for treatment failure may contribute to a more tailored approach to IBD therapy.

Cited by 39 publications

References 39 publications

Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions

Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions

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

Conceptual Model of Lean Body Mass in Pediatric Inflammatory Bowel Disease

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