Journal article
Obesity Is Associated With Worsened Outcomes in Patients With Ulcerative Colitis on Advanced Therapies: A Propensity Matched Cohort Study From the US
Alimentary pharmacology & therapeutics, v 61(7), pp 1197-1207
Apr 2025
PMID: 39844347
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundObesity has been linked to a more severe phenotype in patients with ulcerative colitis (UC).AimTo evaluate the impact of obesity on outcomes of advanced therapies in UC.MethodsWe conducted a retrospective cohort study utilising the TriNetX database comparing the composite score of corticosteroid use, change in advanced therapy or colectomy within two years between two cohorts of patients with UC-those with obesity (BMI >= 30 kg/m2) and those without (BMI 18.5-24.9). The risk assessment was stratified to specific advanced therapies, including tumour necrosis factor alpha inhibitors (TNFi), vedolizumab, ustekinumab and Janus kinase inhibitors (JAKi). We performed 1:1 propensity score matching (PSM) for demographics, co-morbid conditions, laboratory values and IBD medications including corticosteroids.ResultsThere were 3904, 2025, 1150 and 477 patients on TNFi, vedolizumab, ustekinumab and JAKi, respectively, in the UC obesity cohort. After PSM, the UC obesity cohort was at an increased risk of the composite outcome of corticosteroid use, change in therapy and colectomy compared to the UC control cohort in patients on TNFi (aHR 1.37, 95% CI 1.29-1.49), vedolizumab (aHR 1.29, 95% CI 1.16-1.43), ustekinumab (aHR 1.1.26, 95% CI 1.10-1.44) and JAKi (aHR 1.38, 95% CI 1.13-1.69). Sub-group analysis based on the specific TNFi also showed an increased risk of composite outcome for infliximab (aHR 1.36, 95% CI 1.22-1.52) and adalimumab (aHR 1.26, 95% CI 1.11-1.42) within 2 years.ConclusionsObesity is associated with lower efficacy of several advanced therapies in patients with UC.
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Details
- Title
- Obesity Is Associated With Worsened Outcomes in Patients With Ulcerative Colitis on Advanced Therapies: A Propensity Matched Cohort Study From the US
- Creators
- Aakash Desai - Allegheny Hlth Network, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA USAPriya Sehgal - Thomas Jefferson UniversityHimsikhar Khataniar - Allegheny Gen Hosp, Dept Internal Med, Pittsburgh, PA USAJames D. Lewis - College Station Medical CenterFrancis A. Farraye - Mayo Clin, Inflammatory Bowel Dis Ctr, Div Gastroenterol & Hepatol, Jacksonville, FL USAGary R. Lichtenstein - College Station Medical CenterGursimran S. Kochhar - Allegheny Hlth Network, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA USA
- Publication Details
- Alimentary pharmacology & therapeutics, v 61(7), pp 1197-1207
- Publisher
- Wiley
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001402084300001
- Scopus ID
- 2-s2.0-85215669976
- Other Identifier
- 991022135684904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology
- Pharmacology & Pharmacy