Effect of Obesity on Risk of Hospitalization, Surgery, and Serious Infection in Biologic-Treated Patients With Inflammatory Bowel Diseases: A CA-IBD Cohort Study.
Biological Products
/ therapeutic use
Cohort Studies
Colitis, Ulcerative
/ complications
Crohn Disease
/ complications
Hospitalization
Humans
Inflammatory Bowel Diseases
/ chemically induced
Infliximab
/ therapeutic use
Obesity
/ complications
Overweight
/ complications
Retrospective Studies
Tumor Necrosis Factor Inhibitors
/ therapeutic use
Tumor Necrosis Factor-alpha
Ustekinumab
/ therapeutic use
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
01 10 2022
01 10 2022
Historique:
received:
16
01
2022
accepted:
22
04
2022
pubmed:
17
8
2022
medline:
7
10
2022
entrez:
16
8
2022
Statut:
ppublish
Résumé
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). We created an EHR-based cohort of adult patients with IBD who were new users of biologic agents (tumor necrosis factor [TNF-α] 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. Of 3,038 biologic-treated patients with IBD (69% with Crohn's disease and 76% on TNF-α antagonists), 28.2% (n = 858) were overweight, and 13.7% (n = 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, 1.11 [0.73-1.71]). Similar results were observed on stratified analysis by disease phenotype (Crohn's disease vs ulcerative colitis) and index biologic therapy (TNF-α antagonists vs non-TNF-α antagonists). In a multicenter, EHR-based cohort of biologic-treated patients with IBD, obesity was not associated with hospitalization, surgery, or serious infections. Further studies examining the effect of visceral obesity on patient-reported and endoscopic outcomes are needed.
Identifiants
pubmed: 35973139
doi: 10.14309/ajg.0000000000001855
pii: 00000434-202210000-00022
doi:
Substances chimiques
Biological Products
0
Tumor Necrosis Factor Inhibitors
0
Tumor Necrosis Factor-alpha
0
Infliximab
B72HH48FLU
Ustekinumab
FU77B4U5Z0
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1639-1647Subventions
Organisme : NHGRI NIH HHS
ID : R01 HG011066
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026552
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL136835
Pays : United States
Organisme : NIDDK NIH HHS
ID : R03 DK129631
Pays : United States
Organisme : NLM NIH HHS
ID : U24 LM013755
Pays : United States
Organisme : NIDDK NIH HHS
ID : K23 DK117058
Pays : United States
Informations de copyright
Copyright © 2022 by The American College of Gastroenterology.
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