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BMI appears to be important in predicting anti-TNF efficacy in Crohn’s

This month's issue of the European Journal of Gastroenterology & Hepatology investigates whether weight-adjusted anti-tumor necrosis factor treatment favours obese patients with Crohn’s disease.

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Adalimumab is a subcutaneous anti-tumor necrosis factor (anti-TNF) agent, effective in inducing and maintaining remission in Crohn’s disease.

Unlike infliximab, adalimumab dosing is not weight adjusted and dose frequency is based on clinical response.

Dr Bhalme and colleagues determined whether obesity is a risk factor for early loss of response to anti-TNF treatment, and whether weight-adjusted anti-TNF treatment is favorable.

A hospital database of Crohn's disease patients receiving anti-tumor necrosis factor treatment was analyzed retrospectively.

The team of doctors assessed the relationship between time to loss of response and BMI by Kaplan–Meier survival curves and a Cox proportional hazards model.

Of the 54 patients, the team observed a significantly shorter time to dose escalation in the BMI of at least 30.

BMI appears to be important in predicting adalimumab efficacy in Crohn’s
European Journal of Gastroenterology & Hepatology

The researchers noed that the Cox proportional hazards model showed that an increased hazard of loss of response to Adalimumab is related to increases in BMI.

Of the 76 patients, the researchers showed that the differences in survival curves were not significant for the BMI groups. .

Dr Bhalme's team concluded, "BMI appears to be important in predicting adalimumab efficacy in Crohn’s disease."

"Infliximab appears to overcome this reduction of efficacy in obese patients."

"A prospective study evaluating the effect of weight on anti-tumor necrosis factor drug response and serum drug levels is warranted."

European Journal of Gastroenterology & Hepatology:2013 25(5) :543-549
30 April 2013

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