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] ...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12277 |
| _version_ | 1819118765998080000 |
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| author | Isaac Rodin Justin Chan Laura Meleady Clare Hii Sally Lawrence Kevan Jacobson |
| author_facet | Isaac Rodin Justin Chan Laura Meleady Clare Hii Sally Lawrence Kevan Jacobson |
| author_sort | Isaac Rodin |
| collection | DOAJ |
| 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/m2) 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/m2 (interquartile range [IQR], 17.3–23.8) and 19.7 kg/m2 (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. |
| first_indexed | 2024-12-22T05:54:05Z |
| format | Article |
| id | doaj.art-b2f0267748aa432bb20ace2d98efe5d2 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-22T05:54:05Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-b2f0267748aa432bb20ace2d98efe5d22022-12-21T18:36:48ZengWileyJGH Open2397-90702020-06-014344645310.1002/jgh3.12277High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel diseaseIsaac Rodin0Justin Chan1Laura Meleady2Clare Hii3Sally Lawrence4Kevan Jacobson5MD Undergraduate Program University of British Columbia Vancouver CanadaDivision of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine University of British Columbia Vancouver CanadaDivision of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine University of British Columbia Vancouver CanadaDivision of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine University of British Columbia Vancouver CanadaDivision of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine University of British Columbia Vancouver CanadaDivision of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine University of British Columbia Vancouver CanadaBackground 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/m2) 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/m2 (interquartile range [IQR], 17.3–23.8) and 19.7 kg/m2 (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.https://doi.org/10.1002/jgh3.12277body mass indexinfliximabobesitypediatric inflammatory bowel disease |
| spellingShingle | Isaac Rodin Justin Chan Laura Meleady Clare Hii Sally Lawrence Kevan Jacobson High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease JGH Open body mass index infliximab obesity pediatric 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 | body mass index infliximab obesity pediatric inflammatory bowel disease |
| url | https://doi.org/10.1002/jgh3.12277 |
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