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Impact of TNF-? Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis.

ABSTRACT: Objective:The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-? 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-? 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-? 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.

SUBMITTER: Patsalos O

PROVIDER: S-EPMC7174757 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis.

Patsalos Olivia O Dalton Bethan B Leppanen Jenni J Ibrahim Mohammad A A MAA Himmerich Hubertus H

Frontiers in pharmacology 20200415

<h4>Objective</h4>The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-α inhibitor therapy on body weight and BMI.<h4>Methods</h4>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-α inhibitors based on pre-specified inclusion criteria. A rando ...[more]

PMID: 32351392

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Project description:ObjectiveCardiovascular disease is an underappreciated issue in prison medicine. Recent studies have revealed a higher prevalence of cardiovascular disease risk factors (CVDRFs) among individuals in prison, but the impact of incarceration on CVDRFs over time is not well understood. This review aimed to assess available literature and quantify the relationship between incarceration and trends in major CVDRFs in high-income countries.DesignSystematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-regression on weight change and obesity.Data sourcesMedline, Embase, PubMed, Cochrane Central Wiley and Web of Science.Eligibility criteria for selecting studiesLongitudinal studies reporting on the incidence of, or trends in any CVDRF among current or former people in prison over time, in high-income countries.Data extraction and synthesisTwo authors independently screened articles for eligibility, extracted data and assessed quality using an adapted version of the Newcastle-Ottawa Scale. Trends in CVDRFs during and following incarceration were summarised and in those with sufficient data a meta-regression was performed.ResultsTwenty-six articles were identified. CVDRFs assessed included obesity, hypertension, diabetes, dyslipidaemia, tobacco use, physical inactivity and unhealthy diet. A meta-regression on change in weight during incarceration found a mean increase of 5.3 kg (95% CI 0.5 to 10.1) and change in body mass index of 1.8 kg/m2 (95% CI -0.9 to 4.6) at 2 years. Weight gain appeared most pronounced right after entering prison and then plateaued at 2 years. Concerning hypertension, the results were inconclusive, despite a trend towards rising blood pressure or prevalence of hypertension during incarceration, and an increased incidence of hypertension following incarceration. Results are contradictory or inconclusive for the other CVDRFs reviewed.ConclusionPossible explanations for the association between incarceration and weight include a sedentary lifestyle, unhealthy diet, forced smoking cessation, psychotropic medication use and high levels of stress. Incarceration may be an independent risk factor for cardiovascular disease.

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Impact of TNF-? Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis.

Publications

Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis.

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