Changes in Anthropometric Parameters After Anti-TNFα Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.
Journal
BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy
ISSN: 1179-190X
Titre abrégé: BioDrugs
Pays: New Zealand
ID NLM: 9705305
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
18
9
2020
medline:
28
4
2021
entrez:
17
9
2020
Statut:
ppublish
Résumé
Tumour necrosis factor (TNF)-α inhibitors have been widely used for the treatment of moderate-to-severe inflammatory bowel disease (IBD). TNFα also plays an important role in the regulation of weight homeostasis and metabolism and has been linked to variations in anthropometric responses. This relationship in patients with IBD has yet to be determined. Our objective was to evaluate the effects of TNFα inhibitors on changes in anthropometric measures in both adults and children with IBD through a systematic review and meta-analysis. Multiple database searches identified studies involving children and adults with IBD and treated with TNFα inhibitors and reporting at least one primary outcome measure. Where possible, data were combined for meta-analysis. The primary outcomes included weight, body mass index (BMI), waist circumference, height, height/velocity, and fat and lean mass. Secondary outcomes included surrogate markers of disease activity. A random-effects model was used to estimate the standardised mean difference (SMD). In total, 23 cohort studies (total 1167 participants) met the inclusion criteria. Meta-analysis was performed on 13 of these studies. In children, 6-29.3 months of anti-TNFα therapy had a small but statistically significant effect on weight (SMD 0.31; 95% confidence interval [CI] 0.12-0.49; P = 0.001) with a mean gain in z score of 0.30 (standard error [SE] 0.12). In adults, 2-22.4 months of treatment had a moderate effect on BMI (SMD 0.72; 95% CI 0.17-1.26; P = 0.010; mean gain 1.23 kg/m Anti-TNFα treatment appears to be associated with an increase in body weight, BMI, and other anthropometric parameters. Given the differing courses of IBD between children and adults, this association should be considered before initiating biologics for undernourished, overweight, and obese patients. Registration: PROSPERO registration number CRD42020163079.
Sections du résumé
BACKGROUND
BACKGROUND
Tumour necrosis factor (TNF)-α inhibitors have been widely used for the treatment of moderate-to-severe inflammatory bowel disease (IBD). TNFα also plays an important role in the regulation of weight homeostasis and metabolism and has been linked to variations in anthropometric responses. This relationship in patients with IBD has yet to be determined.
OBJECTIVES
OBJECTIVE
Our objective was to evaluate the effects of TNFα inhibitors on changes in anthropometric measures in both adults and children with IBD through a systematic review and meta-analysis.
METHODS
METHODS
Multiple database searches identified studies involving children and adults with IBD and treated with TNFα inhibitors and reporting at least one primary outcome measure. Where possible, data were combined for meta-analysis. The primary outcomes included weight, body mass index (BMI), waist circumference, height, height/velocity, and fat and lean mass. Secondary outcomes included surrogate markers of disease activity. A random-effects model was used to estimate the standardised mean difference (SMD).
RESULTS
RESULTS
In total, 23 cohort studies (total 1167 participants) met the inclusion criteria. Meta-analysis was performed on 13 of these studies. In children, 6-29.3 months of anti-TNFα therapy had a small but statistically significant effect on weight (SMD 0.31; 95% confidence interval [CI] 0.12-0.49; P = 0.001) with a mean gain in z score of 0.30 (standard error [SE] 0.12). In adults, 2-22.4 months of treatment had a moderate effect on BMI (SMD 0.72; 95% CI 0.17-1.26; P = 0.010; mean gain 1.23 kg/m
CONCLUSION
CONCLUSIONS
Anti-TNFα treatment appears to be associated with an increase in body weight, BMI, and other anthropometric parameters. Given the differing courses of IBD between children and adults, this association should be considered before initiating biologics for undernourished, overweight, and obese patients. Registration: PROSPERO registration number CRD42020163079.
Identifiants
pubmed: 32940873
doi: 10.1007/s40259-020-00444-9
pii: 10.1007/s40259-020-00444-9
pmc: PMC7519901
doi:
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
649-668Références
J Pediatr Surg. 2000 Jul;35(7):1035-9
pubmed: 10917291
Dig Dis Sci. 2017 Nov;62(11):3110-3116
pubmed: 28895012
Pharmaceuticals (Basel). 2013 Oct 16;6(10):1322-34
pubmed: 24275852
J Clin Endocrinol Metab. 2015 Jul;100(7):2630-9
pubmed: 25919459
MAbs. 2016 Oct;8(7):1407-1416
pubmed: 27589009
J Clin Endocrinol Metab. 2005 Jun;90(6):3510-6
pubmed: 15784704
Psychol Bull. 1992 Jul;112(1):155-9
pubmed: 19565683
Ther Drug Monit. 2019 Jun;41(3):317-324
pubmed: 30633088
Rev Assoc Med Bras (1992). 2017 May;63(5):407-413
pubmed: 28724037
J Pediatr Gastroenterol Nutr. 2009 Feb;48(2):168-74
pubmed: 19179878
Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
pubmed: 19622511
Inflamm Bowel Dis. 2009 Oct;15(10):1476-84
pubmed: 19291781
Inflamm Bowel Dis. 2013 Dec;19(13):2949-56
pubmed: 23945182
Cell Biochem Funct. 2009 Oct;27(7):407-16
pubmed: 19757404
Nutr Clin Pract. 2008 Oct-Nov;23(5):551-6
pubmed: 18849561
Eur J Gastroenterol Hepatol. 2009 Mar;21(3):283-8
pubmed: 19279474
Clin Rheumatol. 2016 Jun;35(6):1615-8
pubmed: 27048267
J Pediatr. 2016 Apr;171:146-52.e1-2
pubmed: 26873656
Ann Pharmacother. 2020 Aug;54(8):729-741
pubmed: 31955605
J Clin Endocrinol Metab. 2018 Mar 1;103(3):936-945
pubmed: 29329430
J Eur Acad Dermatol Venereol. 2013 Feb;27(2):e186-90
pubmed: 22621415
J Crohns Colitis. 2012 Jul;6(6):665-73
pubmed: 22398103
Clin Rheumatol. 2008 Jun;27(6):795-7
pubmed: 18305977
Eur J Gastroenterol Hepatol. 2012 May;24(5):495-500
pubmed: 22387887
Inflamm Bowel Dis. 2007 Apr;13(4):424-30
pubmed: 17206672
J Eur Acad Dermatol Venereol. 2008 Mar;22(3):341-4
pubmed: 18005022
J Eur Acad Dermatol Venereol. 2017 Mar;31(3):490-497
pubmed: 27545848
Lancet. 2000 Oct 28;356(9240):1475-9
pubmed: 11081530
News Physiol Sci. 1998 Dec;13:298-304
pubmed: 11390808
Cells. 2019 Jun 21;8(6):
pubmed: 31234447
Clin Nutr. 2004 Dec;23(6):1430-53
pubmed: 15556267
Am J Clin Nutr. 2005 Jul;82(1):49-52
pubmed: 16002799
Dig Dis Sci. 2015 Jul;60(7):2130-5
pubmed: 25680875
Clin Cases Miner Bone Metab. 2013 Jan;10(1):11-4
pubmed: 23858303
Dermatol Ther. 2011 Jul-Aug;24(4):446-51
pubmed: 21910803
Inflamm Bowel Dis. 2011 Oct;17(10):2162-8
pubmed: 21910178
Dig Liver Dis. 2004 May;36(5):342-7
pubmed: 15191204
Nature. 1985 Aug 8-14;316(6028):552-4
pubmed: 2993897
World J Gastroenterol. 2016 Sep 21;22(35):7868-81
pubmed: 27672284
Best Pract Res Clin Endocrinol Metab. 2005 Dec;19(4):547-66
pubmed: 16311216
J Endocrinol. 2006 May;189(2):319-28
pubmed: 16648299
J Crohns Colitis. 2013 Aug;7(7):e241-8
pubmed: 23040290
J Crohns Colitis. 2013 Jun;7(5):369-76
pubmed: 22483567
J Gastrointestin Liver Dis. 2016 Mar;25(1):49-56
pubmed: 27014753
Dig Liver Dis. 2017 May;49(5):495-499
pubmed: 28096060
Gastroenterology. 1993 Sep;105(3):681-91
pubmed: 8359640
Inflamm Bowel Dis. 2017 Jul;23(7):1182-1186
pubmed: 28410342
Clin Endocrinol (Oxf). 2010 Aug;73(2):220-8
pubmed: 20184596
Arthritis Res Ther. 2010;12(5):R197
pubmed: 20964833
J Crohns Colitis. 2012 Apr;6(3):337-44
pubmed: 22405171
Arch Dis Child. 2003 Nov;88(11):995-1000
pubmed: 14612366
Nat Rev Gastroenterol Hepatol. 2017 Feb;14(2):110-121
pubmed: 27899815
Clin Nutr. 2011 Feb;30(1):86-91
pubmed: 20719413
J Clin Pharmacol. 2015 Aug;55(8):866-74
pubmed: 25735646