Does obesity raise risk of hospitalization, surgery in biologic-treated IBD patients?

Obesity does not increase the likelihood of hospitalization among biologic-treated patients with inflammatory bowel disease (IBD), suggests a recent study.

A team of investigators recruited an electronic health record (HER)-based cohort of adult patients with IBD newly initiated on biologic agents (eg, tumour necrosis factor [TNF-α] antagonists, ustekinumab, and vedolizumab) between 1 January 2010 and 30 June 2017 from five health systems in California, US.

Participants were categorized based on their body mass index (BMI) using the World Health Organization classification: normal BMI, overweight, or obese.

The investigators then performed Cox proportional hazard analysis, adjusted for baseline demographic, disease, and treatment characteristics, to compare the risk of all-cause hospitalization, IBD-related surgery, or serious infections in patients with obesity, those overweight, and those with normal BMI.

A total of 3,038 biologic-treated patients with IBD (69 percent with Crohn’s disease and 76 percent on TNF-α antagonists) were included, of whom 858 (28.2 percent) were overweight and 416 (13.7 percent) were obese.

Obesity did not contribute to an increased risk of hospitalization (adjusted hazard ratio [aHR] vs normal BMI, 0.90, 95 percent confidence interval [CI], 0.72‒1.13), IBD-related surgery (aHR, 0.62, 95 percent CI, 0.31‒1.22), or serious infection (aHR, 1.11, 95 percent CI, 0.73‒1.71).

Stratified analysis by disease phenotype (Crohn’s disease vs ulcerative colitis) and index biologic therapy (TNF-α antagonists vs non‒TNF-α antagonists) revealed similar results.

“Further studies examining the effect of visceral obesity on patient-reported and endoscopic outcomes are needed,” the investigators said.