P164. Quality of life in inflammatory bowel disease patients with and without arthropathies: a prospective longitudinal study with 12-months follow-up
L. Brakenhoff1, R. van den Berg2, F. van Gaalen2, A. van der Meulen-de Jong1, T. Huizinga2, D. Hommes3, D. van der Heijde2, H. Fidder4, 1Leiden University Medical Center, Gastroenterology and Hepatology, Leiden, Netherlands, 2Leiden University Medical Center, Rheumatology, Leiden, Netherlands, 3University of California Los Angeles, Center for Inflammatory Bowel Diseases, Los Angeles, United States, 4University Medical Center Utrecht, Gastroenterology and Hepatology, Utrecht, Netherlands
Arthropathies are the most common extraintestinal manifestation in inflammatory bowel disease (IBD) patients. IBD patients have lower Quality of Life (QoL) than the general population. We assessed the effect of patient-reported factors on QoL in IBD patients with and without arthropathies, prospectively over 1 year.
In total, 181 IBD patients were questioned about joint pain. At baseline, 135 patients (77% Crohn's disease (CD), 34% male) had arthropathies (daily back pain for ≥3 months and/or peripheral joint pain and/or joint swelling during the last year), another 46 patients (74% CD, 50% male) who had no arthropathies served as controls. QoL was assessed by the shortIBDQ and SF-36 (physical (PCS) and mental (MCS) component summary scores). Harvey–Bradshaw Index (HBI) and Simple Clinical Colitis Activity Index (SCCAI) were used to measure IBD activity (active disease if HBI/SCCAI >4). Disease activity and (nocturnal) pain, back and peripheral joints, were scored (11-point numerical rating scale [NRS]). The self-administered questionnaires were assessed every 3-months. Uni- and multivariate (linear mixed model) analyses were performed to investigate which variables (age, gender, type of IBD, IBD duration, IBD activity, 6 NRS scores, smoking and employment) were associated with QoL. Variables with a p < 0.20 were included in multivariate analyses. Because of the strong correlation between the 6 NRS scores, we included 2 of 6 scores in the multivariate analyses.
The mean age and mean IBD disease duration of all patients (n = 181) were 43.6±13.7 and 15.6±11.1 years, respectively. Multivariate analysis showed that an increase in NRS of disease activity back and peripheral joints and IBD activity were independently negatively associated with shortIBDQ (all p < 0.001). Increased IBD duration and employment were independently positively associated with shortIBDQ (both p < 0.05). Back and peripheral joint pain, IBD activity and unemployment were independently negatively associated with PCS (all p < 0.001). Disease activity of peripheral joints and IBD were independently negatively (both p < 0.001), and employment and age independently positively associated with MCS (both p < 0.05).
An increase in severity of back and peripheral joint pain, disease activity of the back and peripheral joints and IBD activity are independently negatively associated with QoL in IBD patients. Furthermore, employment, increased IBD duration and age are independently positively associated with QoL.