TY - JOUR
T1 - Impact of TNF-a inhibitors on body weight and BMI
T2 - A Systematic Review and Meta-Analysis
AU - Patsalos, Olivia
AU - Dalton, Bethan
AU - Leppanen, Jenni
AU - Ibrahim, Mohammad A A
AU - Himmerich, Hubertus
N1 - Copyright © 2020 Patsalos, Dalton, Leppanen, Ibrahim and Himmerich.
PY - 2020/4/15
Y1 - 2020/4/15
N2 - Objective: The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-a inhibitor therapy on body weight and BMI. Methods: Three databases (PubMed, OVID, and EMBASE) were systematically searched from inception to August 2018. We identified prospective, retrospective, and randomized controlled studies in adults with immune-mediated inflammatory diseases treated with TNF-a inhibitors based on pre-specified inclusion criteria. A random-effects model was used to estimate standardised mean change (SMCC). Results: Twenty-six longitudinal studies with a total of 1,245 participants were included in the meta-analysis. We found evidence for a small increase in body weight (SMCC=0.24, p=.0006, 95% CI [0.10, 0.37]) and in BMI (SMCC=0.26, p <.0001, 95% CI [0.13, 0.39]). On average, patients gained 0.90kg (SD=5.13) under infliximab, 2.34kg (D=5.65) under etanercept and 2.27kg (SD=4.69) during treatment with adalimumab within the duration of the respective studies (4-104 weeks). Conclusion: Our results yield further support the for the view that TNF-a inhibitors increase body weight and BMI as a potential side effect. Modulating cytokine signaling could be a future therapeutic mechanism to treat disorders associated with weight changes such as anorexia nervosa.
AB - Objective: The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-a inhibitor therapy on body weight and BMI. Methods: Three databases (PubMed, OVID, and EMBASE) were systematically searched from inception to August 2018. We identified prospective, retrospective, and randomized controlled studies in adults with immune-mediated inflammatory diseases treated with TNF-a inhibitors based on pre-specified inclusion criteria. A random-effects model was used to estimate standardised mean change (SMCC). Results: Twenty-six longitudinal studies with a total of 1,245 participants were included in the meta-analysis. We found evidence for a small increase in body weight (SMCC=0.24, p=.0006, 95% CI [0.10, 0.37]) and in BMI (SMCC=0.26, p <.0001, 95% CI [0.13, 0.39]). On average, patients gained 0.90kg (SD=5.13) under infliximab, 2.34kg (D=5.65) under etanercept and 2.27kg (SD=4.69) during treatment with adalimumab within the duration of the respective studies (4-104 weeks). Conclusion: Our results yield further support the for the view that TNF-a inhibitors increase body weight and BMI as a potential side effect. Modulating cytokine signaling could be a future therapeutic mechanism to treat disorders associated with weight changes such as anorexia nervosa.
KW - TNF-alpha
KW - BMI
KW - weight change
KW - cytokines
KW - Anorexia nervosa
KW - adalimumab
KW - Infliximab
KW - Etanercept
UR - http://www.scopus.com/inward/record.url?scp=85084400757&partnerID=8YFLogxK
U2 - 10.3389/fphar.2020.00481
DO - 10.3389/fphar.2020.00481
M3 - Review article
C2 - 32351392
SN - 1663-9812
VL - 11
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
M1 - 481
ER -