本研究旨在评估抗 TNF 治疗开始时超重和肥胖对炎症性肠病 (IBD) 儿童治疗反应和复发率的影响。这项多中心、回顾性队列研究包括 14 个国家的 22 个 IBD 中心。诊断患有 IBD 并接受抗肿瘤坏死因子（抗 TNF）治疗的儿童也被纳入其中；将超重/肥胖的儿童与营养良好/营养不良的儿童进行比较。包括 637 名儿童（370 名 [58%] 男性；平均年龄 11.5±3.5 岁）； 140 人 (22%) 属于超重/肥胖组 (OG)，497 人 (78%) BMI ≤ 1 SD (CG)。平均随访时间为 141±78 周（中位 117 周）。在整个随访过程中，各组之间抗 TNF 反应丧失（LOR）没有差异。然而，接受 OG 治疗的儿童比对照组的儿童剂量增加更多。男性和在抗 TNF 治疗开始时缺乏伴随的免疫调节剂是与 LOR 相关的危险因素。引入抗 TNF 药物后第一年的复发率没有差异；然而，在随访结束时，OG 中的复发率明显高于 CG 中的复发率（分别为 89 [64%] 和 218 [44%]，P < .001）。单变量和多变量分析显示，超重/肥胖、患有 UC 或男性是与复发风险较高相关的因素。超重/肥胖的 IBD 儿童对抗 TNF 药物的 LOR 风险并不较高。引入抗 TNF 药物后第一年复发，但随访结束时复发风险增加。© 作者 2024。由牛津大学出版社代表克罗恩病出版

This study aimed to evaluate the effect of overweight and obesity at the start of anti-TNF therapy on treatment response and relapse rate in children with inflammatory bowel disease (IBD).This multicenter, retrospective cohort study included 22 IBD centers in 14 countries. Children diagnosed with IBD in whom antitumor necrosis factor (anti-TNF) was introduced were included; those who were overweight/obese were compared with children who were well/undernourished.Six hundred thirty-seven children (370 [58%] males; mean age 11.5 ± 3.5 years) were included; 140 (22%) were in the overweight/obese group (OG) and 497 (78%) had BMI ≤1 SD (CG). The mean follow-up time was 141 ± 78 weeks (median 117 weeks). There was no difference in the loss of response (LOR) to anti-TNF between groups throughout the follow-up. However, children in OG had more dose escalations than controls. Male sex and lack of concomitant immunomodulators at the start of anti-TNF were risk factors associated with the LOR. There was no difference in the relapse rate in the first year after anti-TNF introduction; however, at the end of the follow-up, the relapse rate was significantly higher in the OG compared with CG (89 [64%] vs 218 [44%], respectively, P < .001). Univariate and multivariate analysis revealed that being overweight/obese, having UC, or being of male sex were factors associated with a higher risk for relapse.Overweight/obese children with IBD were not at a higher risk of LOR to anti-TNF. Relapse in the first year after anti-TNF was introduced, but risk for relapse was increased at the end of follow-up.© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.