title: The Effect of anti-TNFα Induction Therapy on the Nutritional Status and Dietary Intake in Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Patients suffering from inflammatory bowel disease (IBD) are at a high risk of malnutrition and retain an altered body composition. We hypothesized that anti-tumor necrosis factor (anti-TNF) alpha therapy may improve dietary intake and have a beneficial influence on body composition in these patients.
  
  
  METHODS
  Our study involved 40 IBD outpatients (33 Crohn's disease, 7 ulcerative colitis); 24 of these received adalimumab (160/80/40EOW) and 16 were treated with infliximab (5 mg/kg at week 0, 2, 6, and subsequently every 8 weeks). Body composition was measured with bioelectrical impedance analysis, while dietary intake was recorded prior to initiating biologicals and 3 months afterwards. Body composition indexes: fat-free mass index [FFMI], body fat mass index [BFMI]) were calculated in kg/m2.
  
  
  RESULTS
  Baseline BMI (kg/m2) and muscle parameters increased significantly at the end of the observational period (BMI: 23.81+/-7.19 vs. 24.52+/-7.34, p<0.001; FFMI: 17.64+/-3.00 vs. 18.14+/-3.08, p<0.001; at week 0 vs. 12, respectively). However, no significant changes were detected in the fat parameters (BFMI: 6.21+/-5.20 vs. 6.44+/-5.27, respectively). We found no significant difference between the effects of adalimumab vs. infliximab on body composition (deltaFFMI: 0.55+/-0.82 vs. 0.43+/-0.69; deltaBFMI: 0.23+/-0.85 vs. 0.21+/-1.01, respectively). No significant difference was observed in the extent of changes in parameters whether the patients were on corticosteroids (n=15) or not (n=25) at week 0 (deltaFFMI: 0.44+/-0.84 vs 0.59+/-0.72; deltaBFMI: 0.36+/-1.12 vs. 0.09+/-0.71, respectively).
  
  
  CONCLUSIONS
  Our findings suggest that muscle parameters improved during the anti-TNF induction therapy, while fat parameters did not change significantly. Thus, induction anti-TNF therapy might have a beneficial effect on body composition.
authors.affiliation: 2nd Department of Medicine; Budapest, Hungary. csontosagnesanna@gmail.com.
authors.forename: Ágnes Anna
authors.initials: ÁA
authors.lastname: Csontos
authors.affiliation: School of PhD Studies, Pathological Sciences, Health Science Research, Budapest, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Molnár
authors.affiliation: 2nd Department of Medicine; Budapest, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Piri
authors.affiliation: 2nd Department of Medicine; Budapest, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Katona
authors.affiliation: Faculty of Health Sciences Department of Dietetic and Nutrition Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Sarolta
authors.initials: S
authors.lastname: Dakó
authors.affiliation: Faculty of Health Sciences Department of Dietetic and Nutrition Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Pálfi
authors.affiliation: 2nd Department of Medicine; Budapest, Hungary.
authors.forename: Pál
authors.initials: P
authors.lastname: Miheller
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D004435:Eating / Q000187:drug effects*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000187:drug effects*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab