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N816 Anti-TNF therapy improves the quality of life in patients with ulcerative colitis

Silva R.P.L., Baima J.P., Bissoli G.C., Farinelli E., Sibia C.F., Barros J.R., Biondi R.B., Renosto F.L., Hossne R.S., Sassaki L.Y.

Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brazil

Background

Inflammatory bowel disease (IBD) is characterized by a chronic relapsing inflammation of the gastrointestinal tract. The major subtypes are Crohn's disease (CD) and ulcerative colitis (UC). The symptoms can have significant psychosocial implications that can affect the health-related quality of life (HRQoL). Anti-TNF agents are not only effective at inducing remission but have also been shown to improve HRQoL. Given the importance of restoration of health and improvement of HRQoL in UC patients, the purpose of the present study was to determine the impact of the treatment with anti-TNF agents on the improvement of patient's quality of life.

Methods

A prospective, longitudinal study was performed on patients with UC treated with anti-TNF agents. Biological treatment was indicated for patients with moderate and severe colitis refractory to immunosuppressants or steroids refractory or steroids dependent, and those admitted to the hospital with severe colitis, when they were steroid refractory or dependent. The inflammatory bowel disease questionnaire (IBDQ) was used to measure the HRQoL at baseline and at weeks 14, 30 and 54. The Mayo score was used to assess the clinical response of UC patients. Statistical Analysis: variables were analyzed at four time points using variance analysis of repeated measurements (ANOVA) with the Tukey post-test. This study was approved by the Research Ethics Committee (CAAE: 57721515.7.0000.5411).

Results

Thirty-one patients were included in this study. Eighteen (58.06%) were male, 96.77% Caucasian race, mean age was 46.02y (± 15.7) and disease duration was 4.84y (± 4.0). Location data included 80.65% with pancolitis, 19.35% with left colitis, and no patients with distal colitis. The mean of Mayo score at baseline was 7.33 (±3.25) points and the endoscopy sub score was 2.71 (±0.55) points. Anti-TNF therapy included adalimumab in 10 patients and infliximab in 21 patients. Clinical response was achieved in 18 patients (58.06%) in total, and the endoscopy response was achieved in 44.44% of the patients. Patients improved their HRQoL, without differences between groups (p=0.99). In ADA group, the IBDQ score ranges from 115.71 (±51.98) at baseline to 134.14 (±46.03) at week 14 (p=0.99), 165.33 (±61.91) at week 30 (p=0.63) and to 166.00 (±62.56) at week 54 (p=0.60). In IFX group, the IBDQ score ranges from 116.20 (±45.47) at baseline to 154.83 (±50.79) at week 14 (p=0.26), 170.75 (±49.93) at week 30 (p=0.04) and 176.62 (±42.27) at week 54 (p=0.02).

Conclusion

UC patients treated with anti-TNF agents presented an improvement in HRQoL.