Impact of Obesity on Treatment Response in Patients With Chronic Inflammatory Disease Receiving Biologic Therapy: Secondary Analysis of the Prospective Multicentre BELIEVE Cohort Study

Biological therapy is used to treat chronic inflammatory diseases (CIDs); however, up to 50% of patients fail to achieve an adequate clinical response. This study aimed to access the impact of obesity on clinical treatment response in CID patients after 14-16 weeks of biological therapy. This multicentre prospective cohort study enrolled 233 adults between 2017 and 2020 diagnosed with Crohn disease, ulcerative colitis (UC), rheumatoid arthritis, axial spondyloarthritis (PsA), psoriatic arthritis or psoriasis scheduled for biologic therapy. The main analysis population included patients with BMI data before treatment initiation, categorising patients as either obese (BMI ≥ 30 kg/m2) or non-obese (BMI < 30 kg/m2). The primary endpoint was the proportion of patients achieving clinical treatment response after 14-16 weeks. Main analyses were based on logistic regression with a factor for obesity, while adjusted for sex and age. Of the 228 patients eligible for the main analyses, 125 (55%) responded to biologic therapy. In the obese group (n = 59), 30 (51%) patients responded compared to the 95 (56%) individuals categorised as non-obese (n = 169), with no difference between groups (OR: 0.82, 95% CI: 0.43 to 1.60). This study did not find a lower likelihood of response to biologics in obese individuals compared with non-obese counterparts. Trial Registration: ClinicalTrials.gov identifier: NCT03173144.