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P401 Anti-TNF treatments in Crohn's disease and improvement in work productivity and quality of life: an observational study from Turkey

Törüner M.*1, Başaranoğlu M.2, Atuğ Ö.3, Şentürk Ö.4, Akyüz F.5, Ünsal B.6, Över Hamzaoğlu H.7, Tekin F.8, Sezgin O.9, Akpınar H.10, Çelik A.F.11, Tezel A.12, Göktürk H.S.13, Kav T.14

1Ankara University School of Medicine, Gastroenterology, Ankara, Turkey 2Bezmialem Vakif University Faculty of Medicine, Gastroenterology, Istanbul, Turkey 3Marmara University School of Medicine, Gastroenterology, Istanbul, Turkey 4Kocaeli University Faculty of Medicine, Gastroenterology, Izmit, Turkey 5Istanbul University Istanbul Faculty of Medicine, Gastroenterology, Istanbul, Turkey 6Izmir Katip Celebi University, Gastroenterology, Izmir, Turkey 7Acıbadem Fulya Hospital, Gastroenterology, Istanbul, Turkey 8Ege University Medical School, Gastroenterology, Izmir, Turkey 9Mersin University Faculty of Medicine, Gastroenterology, Mersin, Turkey 10Dokuz Eylul University Faculty of Medicine, Gastroenterology, Izmir, Turkey 11Istanbul University Cerrahpasa Medical School, Gastroenterology, Istanbul, Turkey 12Trakya University Faculty of Medicine, Gastroenterology, Edirne, Turkey 13Baskent University Faculty of Medicine, Gastroenterology, Konya, Turkey 14Hacettepe University School of Medicine, Gastroenterology, Ankara, Turkey

Background

Patients with Crohn's disease (CD) experience major deterioration in their work productivity and quality of life (QoL). Objectives of this study were to evaluate long-term effects of anti-TNF agents on work productivity and activity impairment (WPAI) in patients with CD and also to evaluate QoL using the Inflammatory Bowel Disease Questionnaire (IBDQ) and the Short Form Health Survey (SF-36).

Methods

Patients with confirmed diagnosis of CD and initiated anti-TNF treatment were included and followed-up for 12 months in this multicenter, prospective observational post marketing study.

Results

A total of 106 patients were included in this study and 64.2% of the patients were male. Mean (±SD) age was 36.9 (±11.1) years. At baseline, fistula information was available for 36 patients and 63.9% of these fistulas were perianal, whereas 36.1% were ileocutaneous. Intestinal stenosis was detected in 35.6% of the patients (n=38). Most of the stenosis were located in ileum (70.6%) followed by colon (20.6%) and others (8.8%). Extraintestinal symptoms were observed in 25 patients (23.6%). Most frequent extraintestinal symptom was arthritis with 71.4% (n=15). Mean time from first symptom to initiation of anti-TNF treatment was 6.3 (±5.0) years. At 12 months post-start of treatment significant improvements were observed in work productivity comparing to baseline. Improvements in WPAI scores from baseline to the last visit were −24.1% (p=0.003) for work time missed, −18.1% (p=0.006) for activity impairment, −8.5% (p=0.107) for overall work impairment, and −17.0% (p<0.001) for daily activity impairment. Similarly significant improvements (p<0.001) were detected in all components of the IBDQ when compared to baseline. Statistically significant improvements (p<0.05) were detected for all components of SF-36 except for mental health (p=0.109).

Conclusion

Patients with CD experience a significant improvement in their QoL in terms of WPAI, IBDQ and SF-36 during long-term anti-TNF treatment.