P568 Health-related quality of life, work productivity, and satisfaction with treatment amongst inflammatory bowel disease patients receiving adalimumab mono- versus adalimumab combo-therapy
S. Wang*1, R. Jakubanis2, J. Piercy2, M. Skup1
1AbbVie Inc., North Chicago, Illinois, United States, 2Adelphi Real World, Manchester, United Kingdom
Limited real-world data are available regarding the effect of adalimumab (ADA) monotherapy versus ADA combo-therapy (ADA and immunomodulators [IMM]: mercaptopurine, azathioprine, or methotrexate) on health-related quality of life (HRQoL) and satisfaction with treatment in inflammatory bowel disease (IBD) patients.
Data were taken from the 2015 IBD Disease Specific Programme (DSP), a large, cross-sectional, multi-country survey of IBD patients and their gastroenterologists. The survey was conducted in the United Kingdom, France, Germany, Italy, and Spain. Gastroenterologists completed patient record forms including patient demographics, clinical results, symptomology, and details on flares. The patients completed patient self-completion forms including questions about adherence to treatment, satisfaction with the current treatment, the Work Productivity and Activity Impairment questionnaire (WPAI), EuroQoL-5D (EQ-5D-3L) with the visual analogue scale (EQ-5D VAS), and Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Patients on ADA monotherapy were compared with patients receiving ADA combo-therapy. Comparisons between groups were assessed using Fisher’s exact and Chi-squared tests for categorical variables, and Mann–Whitney tests for continuous variables.
In total, 275 moderate-to-severe IBD patients (69 with UC vs 206 with CD) from EU5 were identified and included in the analysis (mean age 38.9 ± 13.9, 50.2% male), with 167 patients receiving ADA monotherapy and 108 patients receiving ADA combo-therapy. No significant differences between the 2 groups were found in the WPAI (mono 27.8 ± 23.6 vs combo 33.5 ± 27.3; p = 0.44), EQ-5D-3L (mono 0.79 ± 0.25 vs combo 0.79 ± 0.26; p = 0.31), or SIBDQ score (mono 45.5 ± 14.2 vs combo 44.0 ± 11.1; p = 0.46). Satisfaction with treatment reported by gastroenterologists and patients were assessed: 48.5% of gastroenterologists were satisfied with the ADA monotherapy, compared with 31.5% satisfaction with ADA combo-therapy (p = 0.006). The proportion of satisfied patients was 50.0% for ADA monotherapy vs 37.5% for ADA combo-therapy (p = 0.16). No differences were found in adherence to treatment (p = 0.34).
The study found no statistical difference in HRQoL, work-productivity loss, or patient-reported satisfaction with the current treatment between patients on ADA monotherapy and ADA combo-therapy. Gastroenterologists were more satisfied with ADA monotherapy. Patient-reported satisfaction with the current treatment was in line with gastroenterologist-reported satisfaction. This suggests that in a real-world setting, ADA monotherapy is as effective as ADA in conjunction with IMM in improving a patients’ HRQoL and reducing work-productivity loss.