Impact of Obesity on Response to Biologic Therapies in Patients with Inflammatory Bowel Diseases

Bassi, Mehak; Singh, Siddharth

doi:10.1007/s40259-022-00522-0

Cited by 16 publications

(8 citation statements)

References 51 publications

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“…An increasing number of reports are establishing a negative impact of obesity on response to biological therapies [9,[26][27][28]. Prevalences of overweight and obese patients in clinical registries range between 40% [5,29] and 57% [30], and 29% [29] and 30% [5], respectively, with overweight/obese patients showing lower responses to biologics and a higher risk of treatment discontinuation [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Tildrakizumab Across Different Body Weights in Moderate-to-Severe Psoriasis Over 5 Years: Pooled Analyses from the reSURFACE Pivotal Studies

Thaçi

Gerdes

Jardin

et al. 2022

Dermatol Ther (Heidelb)

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Introduction: Tildrakizumab (TIL), a monoclonal antibody that selectively targets interleukin-23p19, has been approved for the treatment of moderate-to-severe plaque psoriasis. According to the European Medicines Agency Summary of Product Characteristics, the recommended dose is 100 mg, but a 200 mg dose can be used in patients with certain characteristics, such as a high disease burden or body weight (BW) C 90 kg. Fixed one-dose biological therapies tend to become less effective in patients with high BW. This post-hoc study describes the long-term efficacy of TIL across different BWs in pivotal clinical trials. Methods: A 5-year pooled analysis of two double-blind, randomised, controlled phase III trials-reSURFACE 1 and 2-was performed. Efficacy measures were the proportions of the patients with an absolute Psoriasis Area and Severity Index (PASI) of \ 3 and \ 1 and a Dermatology Life Quality Index (DLQI) of 0/1. The study population included patients randomised to TIL 100 mg or TIL 200 mg who received C 1 TIL dose up to week 12 (part 1 of the trial) or up to week 28 (part 2) and patients who were responders (C 75% improvement in PASI) to TIL 100 or TIL 200 mg at week 28 and who were maintained on the same dose up to week 244. Efficacy was evaluated by analysing BW subgroups at weeks 28, 52 and 244. Missing data were analysed using multiple imputation. Safety was assessed in the all-patients-as-treated population.Results: The proportions of TIL-treated patients with PASI \ 3 and \ 1 (up to week 244) and DLQI 0/1 (up to week 52) were similar for patients with BW \ 90 or C 90 kg, regardless of dose. Patients C 120 kg had greater efficacy outcomes at the 200 mg dose. Safety outcomes were similar regardless of treatment dose and weight (\ 120/C 120 kg). Conclusion: In patients with BW C 120 kg, TIL 200 mg is more efficacious than TIL 100 mg,

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Section: Discussionmentioning

confidence: 99%

Efficacy of Tildrakizumab Across Different Body Weights in Moderate-to-Severe Psoriasis Over 5 Years: Pooled Analyses from the reSURFACE Pivotal Studies

Thaçi

Gerdes

Jardin

et al. 2022

Dermatol Ther (Heidelb)

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“…Since NAFLD is strongly associated with obesity, it is difficult to separate its impact from that of obesity in general on IBD outcomes. As there exists a significant body of literature on the latter association [41][42][43][44][45][46], careful assessment of any supplementary negative impact attributable to NAFLD is required. In our review, only three studies controlled for obesity in their multivariate regression model [18].…”

Section: Discussionmentioning

confidence: 99%

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Boustany

Rahhal

Mitri

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Evidence suggests that patients with inflammatory bowel disease are at higher risk of developing nonalcoholic fatty liver disease (NAFLD). However, there is limited information currently available on how NAFLD may affect the clinical course of IBD. Thus, we conducted a systematic review to evaluate the impact of NAFLD on IBD-related hospitalization outcomes. All observational studies assessing IBD-related hospitalization outcomes in patients with NAFLD were included. Exclusion criteria were studies published in languages other than English or French, or those involving pediatric population. Outcomes included IBD-related hospitalization and readmission rates, need for surgery, length of stay, inpatient mortality, and costs. Overall, 3252 citations were retrieved and seven studies met the inclusion criteria (1 574 937 patients); all were observational, of high quality, and originated in the United States. Measurable outcomes reported in these studies were few and with insufficient similarity across studies to complete a quantitative assessment. Only one study reports NAFLD severity. Two studies suggested a higher rate of hospitalization for patients with both NAFLD and IBD compared to IBD alone (incidence rate ratio of 1.54; 95% confidence interval: 1.33–1.79). This is the first systematic review to date that evaluates any possible association of NAFLD with IBD-related hospitalization outcomes. Despite the paucity and low quality of available data, our findings indicate that NAFLD may be associated with worse outcomes amongst IBD patients (especially Crohn’s disease). Further and higher certainty of evidence is needed for better characterization of such clinical impact.

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“…In principle, these findings suggest need to modify doses or to measure blood levels of the biological agent when available. Lower efficacy of biological agents has been attributed to high body weight being associated with more rapid clearance and a higher volume of distribution, leading to low trough concentrations 37…”

Section: Obesity May Significantly Impact the Treatment And Complicat...mentioning

confidence: 99%

Ten reasons gastroenterologists and hepatologists should be treating obesity

Camilleri

El-Omar

2023

Gut

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Impact of Obesity on Response to Biologic Therapies in Patients with Inflammatory Bowel Diseases

Cited by 16 publications

References 51 publications

Efficacy of Tildrakizumab Across Different Body Weights in Moderate-to-Severe Psoriasis Over 5 Years: Pooled Analyses from the reSURFACE Pivotal Studies

Efficacy of Tildrakizumab Across Different Body Weights in Moderate-to-Severe Psoriasis Over 5 Years: Pooled Analyses from the reSURFACE Pivotal Studies

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Ten reasons gastroenterologists and hepatologists should be treating obesity

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