The prevalence of malnutrition and the evolution of nutritional status in patients with moderate to severe forms of Crohn's disease treated with Infliximab.
OBJECTIVE
Malnutrition is variably encountered in adult patients with Crohn's disease. We evaluated the nutritional status at the beginning and during Infliximab treatment in patients with Crohn's disease.


METHODS
Patients with moderate/severe flares of disease treated with Infliximab for induction and maintenance of remission were included in a prospective observational study. Body Mass Index and Nutritional Risk Index were calculated in each patient at 0, 6 weeks and than every 8 weeks for one year.


RESULTS
From 30 patients treated with Infliximab 59.3% had low BMI, 35.7% being undernourished. The severity of Crohn's disease did not correlate with low BMI but did correlate with Nutritional Risk Index (p = 0.001). In all patients that responded to Infliximab treatment progressive weight gain was observed, all but one patient reaching normal BMI after one year. Mean weight gain was significantly more elevated (p = 0.001) and time needed to reach normal BMI was longer in the undernutrition group (p = 0.01). Clinical remission was the principal factor associated with weight gain (p = 0.001), while there was no influence of endoscopic remission on nutritional status.


CONCLUSIONS
In patients with moderate/severe forms of Crohn's disease malnutrition is frequently encountered. Induction and maintenance treatment with Infliximab determines weight gain and corrects malnutrition in all patients with clinical remission.
Vadan
Roxana
R
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute for Digestive Diseases and Liver Transplantation, 258 Fundeni Street, Sector 2, 022328 Bucharest, Romania. roxanavadan@yahoo.com
Gheorghe
Liliana Simona
LS
Constantinescu
Alexandrina
A
Gheorghe
Cristian
C
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015992:Body Mass Index; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab