The Effect of anti-TNFα induction therapy on the nutritional status and dietary intake in inflammatory bowel disease

Abstract

Background & Aims: Patients suffering from inflammatory bowel disease (IBD) are at a high risk of malnutrition and retain an altered body composition. We hypothesized that anti-tumor necrosis factor (anti-TNF) alpha therapy may improve dietary intake and have a beneficial influence on body composition in these patients. Methods: Our study involved 40 IBD outpatients (33 Crohn’s disease, 7 ulcerative colitis), 24 of these received adalimumab (160/80/40EOW) and 16 were treated with infliximab (5 mg/kg at week 0, 2, 6, and subsequently every 8 weeks). Body composition was measured with bioelectrical impedance analysis, while dietary intake was recorded prior to initiating biologicals and 3 months afterwards. Body composition indexes: fat-free mass index [FFMI], body fat mass index [BFMI]) were calculated in kg/m2. Results: Baseline BMI (kg/m2) and muscle parameters increased significantly at the end of the observational period (BMI: 23.81±7.19 vs. 24.52±7.34, p<0.001, FFMI: 17.64±3.00 vs. 18.14±3.08, p<0.001, at week 0 vs. 12, respectively). However, no significant changes were detected in the fat parameters (BFMI: 6.21±5.20 vs. 6.44±5.27, respectively). We found no significant difference between the effects of adalimumab vs. infliximab on body composition (deltaFFMI: 0.55±0.82 vs. 0.43±0.69, deltaBFMI: 0.23±0.85 vs. 0.21±1.01, respectively). No significant difference was observed in the extent of changes in parameters whether the patients were on corticosteroids (n=15) or not (n=25) at week 0 (deltaFFMI: 0.44±0.84 vs 0.59±0.72, deltaBFMI: 0.36±1.12 vs. 0.09±0.71, respectively). Conclusion: Our findings suggest that muscle parameters improved during the anti-TNF induction therapy, while fat parameters did not change significantly. Thus, induction anti-TNF therapy might have a beneficial effect on body composition. © 2016, Romanian Society of Gastroenterology. All rights reserved.