Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jun;101(6):e70035.
doi: 10.1111/sji.70035.

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

Klara Riber Eggers  1   2 , Karen Mai Møllegaard  1   2 , Laura Gregersen  1   2 , Silja Hvid Overgaard  1   2   3   4 , Zainab Hikmat  1   2 , Torkell Ellingsen  3 , Jens Kjeldsen  5 , Andreas Kristian Pedersen  6   7 , Sofie Ronja Petersen  6 , Mohamad Jawhara  8 , Anders Bathum Nexøe  2 , Anette Bygum  9 , Christian Lodberg Hvas  10   11 , Jens Frederik Dahlerup  10   11 , Frederik Olof Bergenheim  12 , Henning Glerup  13 , Jacob Broder Brodersen  2   14 , Heidi Lausten Munk  15   16 , Natalia Pedersen  17 , Ole Haagen Nielsen  18 , Karina Winther Andersen  2   19 , Berit Lillenthal Heitmann  20   21 , Robin Christensen  3   4 , Vibeke Andersen  1   2   6
Affiliations
Multicenter Study

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

Klara Riber Eggers et al. Scand J Immunol. 2025 Jun.

Abstract

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.

Keywords: Crohn disease; autoimmune disease; axial spondyloarthritis; biological therapy; body mass index; psoriasis; psoriatic arthritis; rheumatoid arthritis; treatment outcome; ulcerative colitis.

PubMed Disclaimer

Conflict of interest statement

V.A. has served as advisory board member for MSD (Merck). J.B.B. has served as a consultant for Janssen‐Cilag A/S, and support for attending meetings with Pfiser and Tillots. R.C. has served as a consultant for IAG and Compass Communications Ltd. R.C. has served as statistical editor for Osteoarthritis and Cartilage. R.C. has served as statistical editor for Acta Orthopaedica. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the enrolment of participants. Number of patients who were screened, enrolled in the study, and included in the analysis. Patients screened for eligibility were not explicitly recorded in the study. ITT, intention‐to‐treat; Non‐obese, BMI < 30 kg/m2; Obese, BMI ≥ 30 kg/m2; SF‐12, short form health survey.
FIGURE 2
FIGURE 2
Forest plot displaying the odds ratio (OR), derived from a logistic regression model of the included chronic inflammatory diseases (CIDs) on the intention to treat (ITT) population. Clinical treatment response to biologic agents was compared between patients grouped as obese (BMI ≥ 30 kg/m2) or non‐obese (BMI < 30 kg/m2). Missing data were handled using maximum likelihood estimation. The horizontal lines represent the OR ± 95% confidence interval. axSpA, axial spondyloarthritis; CD, Crohn's disease; CI, confidence interval; PsA, psoriatic arthritis; PsO, psoriasis; RA, rheumatoid arthritis; UC, ulcerative colitis.
FIGURE 3
FIGURE 3
Receiver operating characteristic curve analysis for the predictive value of the various body mass index (BMI) values.
See this image and copyright information in PMC

References

    1. Molodecky N. A., Soon I. S., Rabi D. M., et al., “Increasing Incidence and Prevalence of the Inflammatory Bowel Diseases With Time, Based on Systematic Review,” Gastroenterology 142 (2012): 46–54. - PubMed
    1. Wang R., Li Z., Liu S., and Zhang D., “Global, Regional and National Burden of Inflammatory Bowel Disease in 204 Countries and Territories From 1990 to 2019: A Systematic Analysis Based on the Global Burden of Disease Study 2019,” BMJ Open 13 (2023): e065186. - PMC - PubMed
    1. Agrawal M. and Jess T., “Implications of the Changing Epidemiology of Inflammatory Bowel Disease in a Changing World,” United European Gastroenterology Journal 10 (2022): 1113–1120. - PMC - PubMed
    1. Cao F., He Y. S., Wang Y., et al., “Global Burden and Cross‐Country Inequalities in Autoimmune Diseases From 1990 to 2019,” Autoimmunity Reviews 22 (2023): 103326. - PubMed
    1. Cross M., Smith E., Hoy D., et al., “The Global Burden of Rheumatoid Arthritis: Estimates From the Global Burden of Disease 2010 Study,” Annals of the Rheumatic Diseases 73 (2014): 1316–1322. - PubMed

Publication types

Substances

Associated data