Obesity may not affect unplanned health care utilization, safety of therapy in IBD
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SAN DIEGO — Obesity was not linked to hospitalization, surgery or serious infection among a subset of biologic-treated patients with inflammatory bowel disease, according to research presented at Digestive Disease Week 2022.
“Obesity is a risk factor for suboptimal biological response, and population pharmacokinetic studies have consistently shown that increased body mass is associated with increased clearance and decreased stroke levels,” Phillip T. Gu, MD, of Cedars-Sinai Medical Center in Los Angeles, said. “There's very limited data on how obesity affects treatment-related complications such as infections. To further characterize how obesity impacts perceptions in IBD, we aim to evaluate the association between obesity with hospitalization, surgery and serious infection.”
Gu and colleagues identified 3,038 adults with IBD (69% Crohn’s disease) from a California-based electronic health record system who were newly treated with biologics (76% on tumor necrosis factor-alpha antagonists) between January 2010 and June 2017. Based on WHO guidelines, they classified patients as normal BMI, overweight (28.2%) or obese (13.7%) and compared the risk for all-cause hospitalization, IBD-related surgery and serious infection between cohorts.
Following biologic initiation, obesity was not associated with an increased risk for hospitalization (23% vs. 22% vs. 23% in patients classified as obese, overweight or normal BMI, respectively; adjusted HR in obese vs. normal BMI patients = 0.9; 95% CI, 0.72-1.13), IBD-related surgery (2.4% vs. 3.4% vs. 3.5%; aHR = 0.62; 95% CI, 0.31-1.22) or serious infection (6.7% vs. 5.7% vs. 5.6%; aHR = 1.11; 95% CI, 0.73-1.71). Gu noted consistent findings among patients diagnosed with both CD and ulcerative colitis.
Further, increasing BMI modestly associated with a lower risk for hospitalization (per 1kg/m2: aHR = 0.984; 95% CI, 0.969-1) but not IBD-related surgery (aHR = 0.96; 95% CI, 0.916-1.006) or serious infection (aHR = 0.998; 95% CI, 0.974-1.023).
“Obesity was not associated with increased risk for unplanned health care utilization and serious infections,” Gu concluded. “Future studies examining the impact on visceral adiposity on patient-reported and endoscopic outcomes are needed to better inform treatment decisions.”
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Gu P, et al. Abstract 454. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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