Abstract
PURPOSE: Obesity has emerged as a factor influencing outcomes in inflammatory bowel disease (IBD), yet its effect on the persistence of advanced biologic therapies, especially in Asian populations, remains unclear. This study evaluates obesity's impact on clinical outcomes and treatment persistence among Taiwanese IBD patients on advanced biologic therapies. METHODS: This retrospective cohort study was conducted at Chang Gung Memorial Hospital, Taiwan, involving IBD patients on advanced biologics between October 2015 and October 2024. Patients were categorized by BMI into obesity (≥27 kg/m²) and control (<27 kg/m²) groups. Outcomes included 52-week therapy persistence, infections, IBD-related hospitalizations, surgeries, and flare-ups, with persistence compared across biologic agents. RESULTS: Among 555 IBD patients, 68 were obese. Obese patients had distinct characteristics: higher male prevalence (86.8% vs 65.3%), smoking rates (20.6% vs 7.8%), and comorbidities such as hypertension (30.6% vs 13.6%) and cardiovascular disease (11.8% vs 2.5%). Lab results indicated elevated white blood cells, hemoglobin, albumin, and triglycerides, and lower HDL cholesterol in the obesity group. While overall 52-week persistence rates were similar, Ustekinumab showed a lower persistence in obese patients (P = 0.041). CONCLUSION: Obesity in Asian IBD patients is linked to specific clinical traits and comorbidities. Although obesity did not affect overall therapy persistence, Ustekinumab's lower persistence among obese patients suggests the need for tailored treatments. Future studies should explore optimal therapies for obese IBD patients.