P523 Improvement of quality of life and continence in patients with distal ulcerative colitis treated by mesalazine: QUARTZ study

T. Paupard1, F. Gonzalez2, L. Siproudhis3, L. Peyrin-Biroulet4, Thierry Paupard

1Centre Hospitalier de Dunkerque, Gastroenterology, Dunkerque, France, 2Cabinet d’Hépato Gastroentérologie, Gastroenterology, Nîmes, France, 3CHU Pontchaillou, Gastroenterology, Rennes, France, 4CHU Brabois, Gastroenterology, Vandœuvre-lès-Nancy, France

Background

There is no robust data which analysed quality of life, functional disability and continence of patients with distal UC. QUARTZ is the first prospective study in this situation.

Methods

Observational, prospective and multicentric study involving public and private French gastroenterologist to recruit patients with mild to moderate (Mayo score ≥ 3 and ≤ 10) active proctitis or proctosigmoiditis (<20 cm) and under mesalazine for induction treatment. The patients followed for 12 months (±2 months). The primary objective was the quality of life evaluated by Short Inflammatory Bowel Disease (SIBDQ) at 8 weeks (±4 months). The functional disability and incontinence have been evaluated by IBD-Disability Index and Cleveland questionnaires.

Results

From December 2015 to November 2016, 117 patients were recruited. Data of 93 patients have been analysed and results are reported on Table 1. Among the 93 patients, 75 (81%) reached a clinical remission at week 8 with a SIBDQ score improvement of 6.7 ± 7.1 point (p < 0,001). Treatment adherence during the induction period was non-compliance for 76 patients (81%): 17 (18%) patients stopped treatment before W8 (all those patients received rectal formulation). After induction treatment, 72 (77%) patients received maintenance treatment. 11 (12%) patients reported adverse event not linked to the treatment.

Mild, n = 48Moderate, n = 45Total n = 93
Gender, M/F26/2224/2150/43
Age, average ± SD (years)43,7 ± 13,641,5 ± 15,642,7 ± 14,5
UC diagnosed < 1 year, n (%)21(44%)28(62%)49(53%)
Oral mesalazine16(17%)
Topical mesalazine44(47%)
Oral and local33(36%)
Combination with steroid7(15%)5(11%)12(13%)
SIBDQ baseline, average ± SD40,4 ± 7,135,9 ± 9,138,2 ± 8,4
SIBDQ week 844,8 ± 6,1*43,3 ± 7,6*44,1 ± 6,8*
IBD-DI baseline, average ± SD21,5 ± 19,232,7 ± 20,326,9 ± 20,4
IBD-DI week 8, average ± SD14,0 ± 15,317.6 ± 16,015,8 ± 15,7
Cleveland ≥ 4 baseline, n (%)9(19%)11(24%)20(22%)
Cleveland ≥ 4 week 8, n (%)3(6,3%)6(13,3%)9(9,7%)

*p < 0.001 vs. baseline results.

Conclusion

For patients with distal ulcerative colitis treated by mesalazine, quality of life, functional disability and continence have been improved at 8 weeks of treatment despite a poor adherence.