REED - Revista Española de Enfermedades Digestivas

Año 2024 / Volumen 116 / Número 2
Original

Sarcopenia and treatment failure in inflammatory bowel disease: a systematic review and meta-analysis

68-76

DOI: 10.17235/reed.2023.9808/2023

Yue Feng, Weihua Feng, Mei Xu, Chaoping Wu, Huanhuan Yang, Yu Wang, Huatian Gan,

Resumen

Background: The association between sarcopenia and treatment outcomes in inflammatory bowel disease (IBD) is currently a subject of controversy. Methods: A systematic search was performed of PubMed, Embase, Web of Science, and the Cochrane Library for studies published until April 2023. The quality assessment of each included study was performed using the Newcastle-Ottawa Scale. Results: Seventeen studies were included with 2,895 IBD patients. Sarcopenia exhibited an increased risk of treatment failure (OR=2.00, 95% CI: 1.43-2.79) and notably increased the need for surgery (OR=1.54,95%CI:1.06-2.23) as opposed to a pharmacologic treatment plan change (OR=1.19, 95% CI:0.71-2.01) among IBD patients. However, no significant association was found between sarcopenia and treatment failure in corticosteroid (OR=1.21, 95% CI: 0.55-2.64) or biologic agent (OR=1.65, 95% CI: 0.93-2.92) cohorts. Sarcopenia was also linked to elevated treatment failure risks in patients with Crohn's disease (OR=1.82, 95% CI: 1.15-2.90) and those diagnosed with ulcerative colitis (OR=2.55, 95% CI: 1.05-6.21), spanning both Asian (OR=1.88, 95% CI: 1.29-2.74) and non-Asian regions (OR=2.17, 95% CI: 1.48-3.18). Conclusions: Sarcopenia was considered a novel marker for use in clinical practice to predict treatment failure, specifically, the need for surgery in IBD patients. This distinct cohort necessitates clinical attention and tailored care strategies.

Resumen coloquial

Inflammatory bowel disease (IBD), including Crohn‘s disease (CD) and ulcerative colitis (UC), is a chronic disease characterized by a complex genetic disease that is instigated and amplified by the confluence of multiple genetic and environmental variables that perturb the immune-microbiome axis. Sarcopenia is an age-related disease characterized by the loss of muscle mass, impaired motility, or decreased muscle strength. It is a novel predictor of unfavorable clinical outcomes in many diseases. The association between sarcopenia and treatment outcomes in IBD is currently a subject of controversy. Seventeen studies were included in this meta-analysis with a sample size of 2,895 IBD patients. Sarcopenia increased the risk of treatment failure (OR 2.00), mainly by increasing the need for surgery (OR 1.54) but not by increasing the need of change of pharmacological treatment (OR 1.19) (for patients receiving either steroids or biologicals at baseline). Sarcopenia impacts treatment failure in both CD and UC, and in studies from different regions of the world.

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Ficha Técnica

Recibido: 28/06/2023

Aceptado: 21/08/2023

Prepublicado: 14/09/2023

Publicado: 07/02/2024

Tiempo de revisión del artículo: 48 días

Tiempo de prepublicación: 78 días

Tiempo de edición del artículo: 224 días

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