%0 Journal Article
%T Effect of Overweight and Obesity on the Response to Anti-TNF Therapy and Disease Course in Children With IBD.
%A Sila S
%A Aloi M
%A Cucinotta U
%A Gianolio L
%A Granot M
%A Hradsky O
%A Hussey S
%A Kang B
%A Karoliny A
%A Kolho KL
%A de Laffolie J
%A Lega S
%A Matar M
%A Norsa L
%A Omiwole S
%A Orlanski-Meyer E
%A Palomino L
%A Rohani P
%A Scarallo L
%A Sladek M
%A Sohouli MH
%A Urlep D
%A Yerushalmy-Feler A
%A Zifman E
%A Hojsak I
%J Inflamm Bowel Dis
%V 0
%N 0
%D 2024 Jul 31
%M 39083286
%F 7.29
%R 10.1093/ibd/izae165
%X <B>BACKGROUND: </B>This study aimed to evaluate the effect of overweight and obesity at the start of anti-TNF therapy on treatment response and relapse rate in children with inflammatory bowel disease (IBD).<BR><B>METHODS: </B>This multicenter, retrospective cohort study included 22 IBD centers in 14 countries. Children diagnosed with IBD in whom antitumor necrosis factor (anti-TNF) was introduced were included; those who were overweight/obese were compared with children who were well/undernourished.<BR><B>RESULTS: </B>Six hundred thirty-seven children (370 [58%] males; mean age 11.5 ± 3.5 years) were included; 140 (22%) were in the overweight/obese group (OG) and 497 (78%) had BMI ≤1 SD (CG). The mean follow-up time was 141 ± 78 weeks (median 117 weeks). There was no difference in the loss of response (LOR) to anti-TNF between groups throughout the follow-up. However, children in OG had more dose escalations than controls. Male sex and lack of concomitant immunomodulators at the start of anti-TNF were risk factors associated with the LOR. There was no difference in the relapse rate in the first year after anti-TNF introduction; however, at the end of the follow-up, the relapse rate was significantly higher in the OG compared with CG (89 [64%] vs 218 [44%], respectively, P < .001). Univariate and multivariate analysis revealed that being overweight/obese, having UC, or being of male sex were factors associated with a higher risk for relapse.<BR><B>CONCLUSIONS: </B>Overweight/obese children with IBD were not at a higher risk of LOR to anti-TNF. Relapse in the first year after anti-TNF was introduced, but risk for relapse was increased at the end of follow-up.<BR>Overweight and obese children with inflammatory bowel disease required more frequent dose escalations, but overall loss of response to anti-TNF therapy was not increased. Furthermore, in the long term, they tend to have a higher risk for relapse.