Anti-TNF Use May Cause Excess Weight Gain in Children With IBD

The use of anti-tumor necrosis factor (anti-TNF) agents is associated with excess weight gain among children with inflammatory bowel disease (IBD), according to a recent study.

Children with active IBD are often underweight. Although anti-TNF agents may be beneficial for inducing remission and restoring growth among these patients, their use in other autoimmune diseases has often been associated with excess weight gain.
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For their study, the researchers assessed 268 children with IBD. All patients included in the study had received anti-TNF therapy for at least 1 year between August 1998 and December 2013. Patients’ median age at first anti-TNF dose was 12.8 years.

Anthropometric data were recorded at time of anti-TNF initiation and yearly. The researchers defined excess weight gain as change in body mass index standard deviation score (ΔBMI SDS). Using this score, patients were classified as being normal to overweight/obese, overweight to obese, or as having a final BMI SDS above 0 and ΔSDS above 0.5.

A total of 69 of the 268 patients had sufficient follow-up for a median of 29.3 months. Results showed that mean weight SDS at baseline was -0.7, and mean BMI SDS was -0.6.

Baseline BMI SDS had indicated that 11.6% of patients were overweight or obese. However, at last follow-up, the mean ΔBMI SDS was 0.50, and 10 (17%) patients demonstrated excess weight gain. Three patients were reclassified from normal to obese, and 7 patients had a final BMI SDS above 0 and ΔSDS above 0.5.

“Pediatric patients with IBD may experience excess weight gain when treated with anti-TNF agents,” the researchers concluded. “Monitoring for this side effect is warranted.”

—Christina Vogt

Reference:

Haas L, Chevalier R, Major BT, Enders F, Kumar S, Tung J. Biologic agents are associated with excessive weight gain in children with inflammatory bowel disease [Published online September 11, 2017]. Dig Dis Sci. doi:10.1007/s10620-017-4745-1.