P116. Impact of arthropathies on health-related quality of life in inflammatory bowel disease patients
L.K. Brakenhoff1, L. de Wijs1, R. van den Berg2, D.M. van der Heijde2, T.W. Huizinga2, H.H. Fidder3, D.W. Hommes4
1LUMC, Gastroenterology, Leiden, Netherlands; 2LUMC, Rheumatology, Leiden, Netherlands; 3UMCU, Gastroenterology, Utrecht, Netherlands; 4UCLA, Division of Digestive Diseases, Los Angeles, United States
Background: Arthropathies are the most common extraintestinal manifestation (EIM) in inflammatory bowel disease (IBD) patients. The aim of this study was to assess the impact of arthropathies on health-related quality of life (HRQoL) in IBD patients, compared to IBD patients without arthropathies.
Methods: One hundred sixty-six IBD patients were questioned about joint complaints. These joint complaints were defined as daily back pain for more than three months and/or peripheral joint pain and/or swelling during the last year. Based on history and physical examination, patients were categorized in one of the two study groups: IBD patients with or without arthropathies. HRQoL was measured using the Short Inflammatory Bowel Disease Questionnaire (sIBDQ), Short Form (SF)-36 Health Survey, and the EuroQol (EQ)-5D. Higher scores indicate better QoL. IBD activity was measured with the HarveyBradshaw Index (HBI) or Simple Clinical Colitis Activity Index (SCCAI). Active disease was defined as a HBI or SCCAI score above 4.
Results: A total of 127 IBD patients with arthropathies (77.2% Crohn's Disease (CD); 33.1% male) and 39 IBD patients without arthropathies (71.8% CD; 48.7% male) completed the questionnaires. The mean age and mean IBD disease duration of all patients were 42.9 and 15.0 years, respectively. Type of IBD (CD and ulcerative colitis (UC)), gender, mean age, mean disease duration, active UC, pouch/stoma, EIMs, smoking at IBD diagnosis and marital status did not differ between the patients with and without arthropathies. However, there were more active CD disease patients (p < 0.001) and smoking patients at study entry (p = 0.001) in the group with arthropathies than in the group without arthropathies. Patients with arthropathies had significantly lower mean sIBDQ scores, compared to IBD patients without arthropathies, 47.3 and 54.9 (p < 0.001). All 8 dimension scores of the SF-36 were significantly lower for IBD patients with arthropathies than those without arthropathies. Finally, the mean score of the EQ-5D was also significantly lower in patients with than without arthropathies (0.68 and 0.85, p < 0.001). Also after adjustment for disease activity, the presence of arthropathies was independently associated with reduced quality of life.
Conclusions: The HRQoL scores, measured with the sIBDQ, SF36 and EQ-5D, in IBD patients with arthropathies are significantly lower than that of IBD patients without arthropathies. However, disease activity of IBD is the strongest determinant of differences in HRQoL.