scholarly journals The Clinical Features of Inflammatory Bowel Disease in Patients with Obesity

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Seong Kyun Kim ◽  
Ho-Su Lee ◽  
Beom-Jun Kim ◽  
Jin Hwa Park ◽  
Sung Wook Hwang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Features ◽  
Bowel Disease ◽  
Medical Records ◽  
Medical Center ◽  
Cumulative Probability ◽  
Prevalence Of Obesity ◽  
Asan Medical ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Background and Aim. The prevalence of obesity is increasing globally as is the prevalence of inflammatory bowel disease (IBD). Herein, we sought to evaluate the characteristics and prognosis of IBD in patients with obesity. Methods. We retrospectively reviewed the medical records of IBD patients who visited Asan Medical center. We used a large, well-characterized referral center-based cohort. The clinical features of IBD patients with body mass index (BMI) over 30 and matched controls with BMI under 30 were compared. Results. Among the 6,803 IBD patients enrolled in the Asan IBD Registry between June 1989 and December 2016, we identified 16 patients with Crohn’s disease (CD) and 27 patients with ulcerative colitis (UC) whose BMI was over 30 at the time of diagnosis. Their clinical characteristics and course were compared with those of 64 and 108 matched patients with CD and UC, respectively. There were no significant differences in the risk of using steroids (hazards ratio (HR) = 0.633 and P = 0.254 ), immunomodulators (HR = 0.831 and P = 0.517 ), and anti-tumor necrosis factor (TNF) therapy (HR = 1.539 and P = 0.351 ) and risk of bowel resections (HR = 1.858 and P = 0.231 ) between CD patients with BMI over 30 and those with BMI under 30; similarly, UC patients did not show significant differences in the risk of using steroids (HR = 0.613 and P = 0.145 ), immunomodulators (HR = 0.492 and P = 0.111 ), anti-TNF therapy (HR = 0.385 and P = 0.095 ), and risk of colectomy (HR = 0.262 and P = 0.104 ). In the subgroup analysis, under-weight UC patients had a higher cumulative probability of needing steroids (HR = 0.2510 and P = 0.042 ), needing immunomodulators (HR = 0.097 and P = 0.014 ), and a higher risk of receiving colectomy (HR = 0.024 and P = 0.019 ) than obese UC patients. Conclusions. Obese IBD patients with CD or UC did not show significantly different clinical features from nonobese IBD patients.

scholarly journals P415 Paradoxical onset of Takayasu’s arteritis in patients with inflammatory bowel disease treated with anti-tumour necrosis factor-α agents

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S422-S422
Author(s):  
Y Matsune ◽  
J Kouyama ◽  
Y Tsuru ◽  
K Shimizu ◽  
S Asami ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Features ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Rare Complication ◽  
Tumour Necrosis Factor Α ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background Takayasu’s arteritis (TA) is a rare complication associated with inflammatory bowel disease (IBD). TA is a granulomatous systemic vasculitis of uncertain aetiology affecting large arteries, predominantly the aorta and its main branches, leading to stenotic and expansible lesions. The estimated prevalence of coexisting of TA in patients with ulcerative colitis (UC) is 0.3%, and that in patients with Crohn’s disease (CD) is 0.1%. Anti-tumour necrosis factor-α (TNF-α) agents are used to treat both TA and IBD, although some patients with IBD paradoxically develop TA during treatment with anti-TNF-α agents. However, data regarding the incidence and clinical features of TA in such cases are lacking. This study was performed to clarify the prevalence, risk factors, and clinical features of TA that develops paradoxically during treatment with anti-TNF-α agents in patients with IBD. Methods Consecutive patients with IBD who were regularly seen at our centre, a tertiary IBD centre in Japan, from 2000 to 2019 were included in this retrospective single-centre study. We evaluated the prevalence of TA according to the presence or absence of treatment with anti-TNF-α agents and the patients’ clinical manifestations. Results Of 1846 patients with UC and 1249 patients with CD, 7 (0.23%) patients with UC developed TA. The prevalence of TA in patients treated with anti-TNF-α agents was significantly higher (4/254, 1.6%) than that in patients without anti-TNF-α agent treatment (3/1592, 0.19%) (p=0.0087, Fisher’s exact test). Among four patients with UC who paradoxically developed TA during treatment with anti-TNF-α agents, three (75%) received infliximab, one (25%) received adalimumab, and one (25%) received golimumab. One was male and three (75%) were female. The median interval from starting treatment with anti-TNF-α agents to diagnosis of TA was 49.0 (34–63) months. All patients had pancolitis as well as persistent active colitis resistant to anti-TNF-α antibody treatment. The treatments for TA administered after anti-TNF-α therapy were as follows: Two (50%) patients discontinued anti-TNF-α agent therapy, three (75%) were treated with prednisolone, and one (25%) received tocilizumab. No patient required an operation for TA. Conclusion To our knowledge, this is the first study to show the prevalence and clinical features of TA in patients with IBD following administration of anti-TNF-α agent therapy. Although TA is a rare complication, our results suggest that it can develop as paradoxical reaction following administration of anti-TNF-α agents.

scholarly journals Risk and characteristics of tuberculosis after anti-tumor necrosis factor therapy for inflammatory bowel disease: a hospital-based cohort study from Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Yong Lee ◽  
Kyunghwan Oh ◽  
Hee Seung Hong ◽  
Kyuwon Kim ◽  
Seung Wook Hong ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Tumor Necrosis Factor ◽  
Incidence Rate ◽  
Bowel Disease ◽  
Clinical Characteristics ◽  
Tumor Necrosis ◽  
Medical Center ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background Anti-tumor necrosis factor (TNF) treatment for inflammatory bowel disease (IBD) increases the risk of tuberculosis (TB) infection. In the present study, we analyzed the clinical characteristics and risks of TB in Korean patients with IBD who received anti-TNF treatment. Methods The study included patients with IBD who were treated using anti-TNF agents between January 2001 and June 2018 at the Asan Medical Center. Overall, 1434 patients with ulcerative colitis or Crohn’s disease were enrolled. We calculated the incidence of active TB infection after anti-TNF treatment and compared the clinical characteristics of the TB group with those of the non-TB group. Results Twenty-one patients (1.46%) developed active TB infection, and the incidence rate of active TB was 366.73 per 100,000 person-years. In total, 198 patients (14.9%) were positive for latent tuberculosis infection (LTBI), of whom only eight (4%) did not complete LTBI treatment. The age at which the anti-TNF therapy was started was significantly higher in the TB group than in the non-TB group (HR 1.041, 95% CI 1.014–1.069, p = 0.002), and as age increased, so did the incidence rate of active TB infection (linearity p < 0.001). There was no significant difference in the incidence rate of LTBI between the TB and non-TB groups (HR 0.896, 95% CI 0.262–3.066, p = 0.862). Conclusions In patients with IBD, the incidence rate of TB increased with age at anti-TNF therapy initiation. Active treatment of LTBI may lower the incidence of TB in patients with IBD who are to undergo anti-TNF therapy.

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