Obesity does not increase risk for serious infection in biologic-treated IBD
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Obesity was not associated with an increased risk for serious infection among patients with inflammatory bowel disease treated with biologics, according to research published in Clinical and Translational Gastroenterology.
“Obesity has been associated with adverse outcomes in patients with IBD. ... Obesity has also been variably associated with inferior response to therapy, particularly with biologic agents, and a lower likelihood of achieving endoscopic remission,” Siddharth Singh, MD, MS, Mayo Clinic, and colleagues wrote. “Although this negative impact of obesity on disease-related complications in patients with IBD has been established, there has been limited evaluation of the impact of obesity on the risk of treatment-related complications, particularly risk of serious infections.”
In a retrospective cohort study, researchers analyzed 5,987 patients with IBD on either tumor necrosis factor-alpha antagonists (n = 4,881) or Entyvio (vedolizumab, Takeda; n = 1,106) to determine the association between obesity (8.8% of patients), biologic therapy use and the risk for serious infection. Cox proportional hazard models compared the risk between obese patients vs. nonobese patients.
Over 7,115 person-years follow-up, 520 patients developed serious infections that commonly included sepsis as well as gastrointestinal and pulmonary infections. The risk for serious infection was comparable between both patient groups (8.8% vs. 8.5%, respectively; HR = 1.15; 95% CI, 0.86-1.54) and after adjusting for covariates, Cox proportion hazard analysis demonstrated that obesity did not correlate with an increased risk for infection (adjusted HR = 0.74; 95% CI, 0.55-1.01). Conversely, researchers noted advanced age, Hispanic race, multimorbidity, recent corticosteroid exposure, opiate use and ED visits correlated with an increased risk for serious infection.
“The prevalence of obesity is increasing, and it may negatively impact treatment response and effectiveness. ... Obese patients treated with biologics are not more susceptible to serious infections, similar to non-obese patients. Hence, these drugs, including higher doses as needed to achieve effectiveness, are safe to use in obese patients with IBD,” Singh told Healio. “Interventions targeting obesity may be attractive adjunctive therapies for obese patients.”
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