@article{98f2cfa404e14f3fb60e9501235c6e48,
title = "High body mass index is associated with increased risk of treatment failure and surgery in biologic-treated patients with ulcerative colitis",
abstract = "Background: Though pharmacokinetic studies suggest accelerated biologic drug clearance with increasing body weight, evidence of obesity's impact on clinical outcomes in biologic-treated patients with ulcerative colitis (UC) is inconsistent. Aim: To evaluate the impact of obesity on real world response to biological therapy in patients with UC. Methods: In a single-centre retrospective cohort study between 2011-2016 of biologic-treated patients with UC, we evaluated treatment response by baseline body mass index (BMI). Primary outcome was treatment failure (composite outcome of IBD-related surgery/hospitalisation or treatment modification including dose escalation, treatment discontinuation or addition of corticosteroids); secondary outcomes were risk of IBD-related surgery/hospitalisation and endoscopic remission. We conducted multivariate Cox proportional hazard analyses to evaluate the independent impact of BMI on clinical outcomes. Stratified analysis by weight-based regimens (infliximab) or fixed-dose regimens (adalimumab, golimumab, vedolizumab, certolizumab pegol) was performed. Results: We included 160 biologic-treated UC patients (50% males, 55% on infliximab) with median (IQR) age 36 y (26-52) and BMI 24.3 kg/m2 (21.4-28.7). On multivariate analysis, each 1 kg/m2 increase in BMI was associated with 4% increase in the risk of treatment failure (adjusted hazard ratio [aHR], 1.04 [95% CI, 1.00-1.08]) and 8% increase in the risk of surgery/hospitalisation (aHR, 1.08 [1.02-1.14]). The effect on treatment failure was seen in patients on weight-based dosing regimens or fixed-dose therapies. Conclusion: BMI is independently associated with increased risk of treatment failure in biologic-treated patients with UC, independent of dosing regimen.",
author = "S. Kurnool and Nguyen, {N. H.} and J. Proudfoot and Dulai, {P. S.} and Boland, {B. S.} and {Vande Casteele}, N. and E. Evans and Grunvald, {E. L.} and A. Zarrinpar and Sandborn, {W. J.} and S. Singh",
note = "Funding Information: Declaration of funding interests: This work was funded through a career development award to Siddharth Singh from the American College of Gastroenterology and the Crohn{\textquoteright}s and Colitis Foundation. The publication (or project) described was partially supported by the National Institutes of Health, Grant TL1TR001443 of CTSA funding (to Soumya Kurnool). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding Information: Declaration of personal interests: Dr. Dulai has received research support, honorarium and travel support from Takeda, and research support from Pfizer. Dr. Zarrinpar received support from NIH K08 DK102902, AASLD Liver Scholar Award, and American Heart Association Beginning Grant-in-Aid (16BGIA27760160) and has consulted for Takeda, Herbalife and Illumina. Dr. Boland received support from CCFA and UCSD KL2 (1KL2TR001444), has consulted for Abbvie and has received research support from Takeda and Janssen. Dr. Vande Casteele has served as a consultant for Boehringer Ingelheim, Janssen, Takeda, and UCB Pharma. Dr. Grunvald has served as a consultant for Takeda, Orexigen, and Rhythm Pharmaceuticals. Dr. Sandborn has served as a consultant and received research funding from Janssen, Abbvie, UCB Pharma, Takeda and Pfizer. Dr. Singh has received research support from Pfizer and AbbVie. Funding Information: Declaration of personal interests: Dr. Dulai has received research support, honorarium and travel support from Takeda, and research support from Pfizer. Dr. Zarrinpar received support from NIH K08 DK102902, AASLD Liver Scholar Award, and American Heart Association Beginning Grant-in-Aid (16BGIA27760160) and has consulted for Takeda, Herbalife and Illumina. Dr. Boland received support from CCFA and UCSD KL2 (1KL2TR001444), has consulted for Abbvie and has received research support from Takeda and Janssen. Dr. Vande Casteele has served as a consultant for Boehringer Ingelheim, Janssen, Takeda, and UCB Pharma. Dr. Grunvald has served as a consultant for Takeda, Orexigen, and Rhythm Pharmaceuticals. Dr. Sandborn has served as a consultant and received research funding from Janssen, Abbvie, UCB Pharma, Takeda and Pfizer. Dr. Singh has received research support from Pfizer and AbbVie. Declaration of funding interests: This work was funded through a career development award to Siddharth Singh from the American College of Gastroenterology and the Crohn's and Colitis Foundation. The publication (or project) described was partially supported by the National Institutes of Health, Grant TL1TR001443 of CTSA funding (to Soumya Kurnool). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons Ltd",
year = "2018",
month = jun,
doi = "10.1111/apt.14665",
language = "English (US)",
volume = "47",
pages = "1472--1479",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "11",
}
