P1072Impact of Obesity on Treatment Response in Inflammatory Bowel Disease Patients

Abstract Background Obesity represents a chronic inflammatory state that may influence the pathogenesis and clinical progress of Inflammatory Bowel Disease (IBD). Its role on treatment response remains complex and multifactorial.1 This study aimed to assess the prevalence of obesity and its impact on clinical and endoscopic outcomes in IBD patients undergoing biologic therapy. Methods This is a prospective study carried out at a tertiary hospital center in Albania including IBD patients under biologic therapy with adalimumab, intravenous infliximab, and vedolizumab. Demographic laboratory and clinical data age, gender, body mass index (BMI), disease location, extent, activity and duration were collected. Endoscopic activity was assessed using the Mayo endoscopic sub score for ulcerative colitis (UC) and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Clinical remission was defined as a total Mayo score ≤2 for UC and a Crohn’s Disease Activity Index (CDAI) 120 for CD. Mucosal healing (MH) was defined as a Mayo endoscopic sub score of 0–1 for UC and an SES-CD ≤2 for CD. Patients were stratified by BMI into non-obese (18.5–29.9 kg/m²) and obese (≥30 kg/m²) groups. The primary outcomes were steroid-free clinical remission and MH at week 52. All analyses were performed with IBM SPSS Statistics version 27.0. Results A total of 131 IBD patients were included (mean age 45.3 ± 15.5 years), 51.1% male. Mean disease duration was 8.5 ± 7.0 years, and mean age at diagnosis was 37.2 ± 12.8 years. 17% of patients were obese. Obesity was significantly associated with lower steroid free clinical remission at week 52 (20% vs 59%; χ²=4.77, p = 0.029; Fisher’s p = 0.038). MH was less frequent in obese individuals, with significantly higher mucosal activity scores at week 52 (χ² = 4.19, p = 0.041; Fisher’s exact p = 0.043). Among laboratory biomarkers, only CRP levels were found higher in obese patients compared with non-obese patients (16.96 vs.7.42 mg/L), although it didn’t reach statistical significance (p = 0.136). Conclusion Obesity was present in 17% of our IBD cohort and was significantly associated with poorer clinical outcomes, including reduced rates of remission and mucosal healing at week 52. These findings highlight the need for targeted weight management strategies in this subgroup. Encouraging weight loss in obese IBD patients may not only enhance general health but also improve therapeutic response and long-term disease control. Reference: 1. Peraza, J., Abbott, E., Shneyderman, M. et al. The Rising Epidemic of Obesity in Patients with Inflammatory Bowel Disease. Curr Treat Options Gastro 22, 134–144 (2024). https://doi.org/10.1007/s11938-024-00453-5 Conflict of interest: Dr. Sina, Marsela: No conflict of interest Pemaj, Xhensila: No conflict of interest Prifti, Skerdi: No conflict of interest Mullaj, Rubin: No conflict of interest Telaku, Skender: No conflict of interest