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High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease

BACKGROUND AND AIM: While weight gain during infliximab therapy in inflammatory bowel disease (IBD) is common, there has been limited research evaluating its impact on infliximab efficacy. METHODS: Primary aims of this study were to determine the frequency of excess weight gain (body mass index [BMI...

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Autores principales: Rodin, Isaac, Chan, Justin, Meleady, Laura, Hii, Clare, Lawrence, Sally, Jacobson, Kevan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273726/
https://www.ncbi.nlm.nih.gov/pubmed/32514452
http://dx.doi.org/10.1002/jgh3.12277
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author Rodin, Isaac
Chan, Justin
Meleady, Laura
Hii, Clare
Lawrence, Sally
Jacobson, Kevan
author_facet Rodin, Isaac
Chan, Justin
Meleady, Laura
Hii, Clare
Lawrence, Sally
Jacobson, Kevan
author_sort Rodin, Isaac
collection PubMed
description BACKGROUND AND AIM: While weight gain during infliximab therapy in inflammatory bowel disease (IBD) is common, there has been limited research evaluating its impact on infliximab efficacy. METHODS: Primary aims of this study were to determine the frequency of excess weight gain (body mass index [BMI] > 25 kg/m(2)) in children with IBD on maintenance infliximab and evaluate the impact on infliximab dosing, serum trough levels, and treatment failure. Secondary aims were to determine differences in weight gain, treatment characteristics, and clinical/biochemical variables between patients with therapeutic and subtherapeutic maintenance therapy trough levels. We performed a retrospective study of 253 pediatric IBD (75.1% Crohn's disease, 23.3% ulcerative colitis, 1.6% IBD‐unclassified) patients on infliximab followed at BC Children's Hospital between January 2013 and January 2018. RESULTS: Median age at infliximab initiation was 13.9 years, median length of follow up was 56.9 months, and 55.7% were males; 10.3% of the cohort demonstrated excess weight gain (7.5% overweight, 2.8% obese). Average mg/kg dosing was not statistically different between groups (normal, overweight, and obese: 6.7, 6.4, and 6.7 mg/kg, respectively, P = 0.52). Median BMI of patients with therapeutic and subtherapeutic trough levels was similar at 19.9 kg/m(2) (interquartile range [IQR], 17.3–23.8) and 19.7 kg/m(2) (IQR, 17.4–21.9), respectively. BMI had no effect on secondary loss of response to infliximab, with no significant difference between normal and high BMI subgroups (13.4 vs. 16.7%, P = 0.9). CONCLUSIONS: In a subgroup of pediatric IBD patients on maintenance infliximab, excess weight gain was not associated with higher weight‐based dosing, lower serum trough levels, or increased risk of treatment failure.
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spelling pubmed-72737262020-06-07 High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease Rodin, Isaac Chan, Justin Meleady, Laura Hii, Clare Lawrence, Sally Jacobson, Kevan JGH Open Original Articles BACKGROUND AND AIM: While weight gain during infliximab therapy in inflammatory bowel disease (IBD) is common, there has been limited research evaluating its impact on infliximab efficacy. METHODS: Primary aims of this study were to determine the frequency of excess weight gain (body mass index [BMI] > 25 kg/m(2)) in children with IBD on maintenance infliximab and evaluate the impact on infliximab dosing, serum trough levels, and treatment failure. Secondary aims were to determine differences in weight gain, treatment characteristics, and clinical/biochemical variables between patients with therapeutic and subtherapeutic maintenance therapy trough levels. We performed a retrospective study of 253 pediatric IBD (75.1% Crohn's disease, 23.3% ulcerative colitis, 1.6% IBD‐unclassified) patients on infliximab followed at BC Children's Hospital between January 2013 and January 2018. RESULTS: Median age at infliximab initiation was 13.9 years, median length of follow up was 56.9 months, and 55.7% were males; 10.3% of the cohort demonstrated excess weight gain (7.5% overweight, 2.8% obese). Average mg/kg dosing was not statistically different between groups (normal, overweight, and obese: 6.7, 6.4, and 6.7 mg/kg, respectively, P = 0.52). Median BMI of patients with therapeutic and subtherapeutic trough levels was similar at 19.9 kg/m(2) (interquartile range [IQR], 17.3–23.8) and 19.7 kg/m(2) (IQR, 17.4–21.9), respectively. BMI had no effect on secondary loss of response to infliximab, with no significant difference between normal and high BMI subgroups (13.4 vs. 16.7%, P = 0.9). CONCLUSIONS: In a subgroup of pediatric IBD patients on maintenance infliximab, excess weight gain was not associated with higher weight‐based dosing, lower serum trough levels, or increased risk of treatment failure. Wiley Publishing Asia Pty Ltd 2019-11-23 /pmc/articles/PMC7273726/ /pubmed/32514452 http://dx.doi.org/10.1002/jgh3.12277 Text en © 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Rodin, Isaac
Chan, Justin
Meleady, Laura
Hii, Clare
Lawrence, Sally
Jacobson, Kevan
High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title_full High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title_fullStr High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title_full_unstemmed High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title_short High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
title_sort high body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273726/
https://www.ncbi.nlm.nih.gov/pubmed/32514452
http://dx.doi.org/10.1002/jgh3.12277
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