Obesity does not impact infliximab response in inflammatory bowel disease patients

Obesity does not appear to affect the response of inflammatory bowel disease (IBD) patients to infliximab, a recent study has shown.

Accessing data from four clinical trials of infliximab on adults with IBD, researchers recruited 1,205 treated patients (mean age 36.7±12.2 years; 51.6 percent male), of whom 14 percent were obese. Participants were also categorized according to quartiles of body mass index (BMI). The primary outcome of the study was clinical remission.

Multivariable logistic regression analysis showed no significant difference in the risk of clinical remission in obese vs nonobese infliximab-treated patients (54.4 percent vs 55.0 percent; odds ratio [OR], 0.92; 95 percent CI, 0.58–1.47; p=0.73).

A similar trend was obtained in the by-quartile analysis (fourth vs first quartile: 49.1 percent vs 47.6 percent; OR, 1.01; 0.71–1.45; p=0.75 for linear trend) and when key covariates were controlled for (adjusted OR, 0.94; 0.60–1.47; p=0.97).

The relationship with clinical remission remained nonsignificant even when BMI was taken as a continuous variable (per 1 kg/m² increase in BMI: adjusted OR, 0.99; 0.96–1.03). Obesity had no significant impact on mucosal healing (adjusted OR, 1.13; 0.55–2.34; p=0.95).

Subgroup analysis according to IBD type also did not significantly alter the trends. Obesity was not significantly associated with clinical remission in infliximab-treated patients with Crohn’s disease (adjusted OR, 0.97; 0.56–1.68; p=0.87) and ulcerative colitis (adjusted OR, 0.86; 0.38–1.92; p=0.98).