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. 2021 Nov 29;11(12):1316. doi: 10.3390/life11121316

Table 1.

TNFI and the effect of weight gain (increased BMI) on drug efficacy.

TNFI Structure and Mechanism Effect on BMI/Weight Gain Influence of BMI on Drug Efficacy Commentary
Infliximab mouse-derived chimeric IgG1; neutralizes both soluble, and membrane-bound TNF-α Significant, gradual increase [8,10,13,14,15,16,17,18,19,20,21,22,23,24] Increased BMI promotes drug discontinuation [11,12,26]
Failing therapy [12]
Steady decrease of PASI-75 with increasing BMI [21]
Increased BMI leads to reduced efficacy and delayed response [27]
Weight-dependent dosing shows to increase efficacy [8,10]
Etanercept prototypic recombinant fusion protein; inhibits only soluble TNF-α Non-uniform [10,19] weight increase [16,17,18,23,24]
Non-statistically significant weight increase [10,25]
BMI increased more in subjects with normal weight at baseline [19]
Pharmacokinetic interactions due to wider adipose tissue [10,26]
Drug discontinuation [11,12,26]
BMI increase affects early clinical response [21]
Weight-dependent dosing not implemented to date [28]; should be taken in consideration to counteract pharmacokinetic issues
Significant weight gain might call for the use of etanercept only in normal BMI individuals [8]
Adalimumab phage display-derived, fully monoclonal antibody Significant mass increase [10,18,19] Pharmacokinetic interactions due to wider adipose tissue [10,26]
Highest drug discontinuation [26]
Strong diminished drug efficacy with BMI increase [8]
No significant relationship between efficacy and body weight [22]
Conflicting studies call for further research to draw definitive conclusions