The Combination of Patient-Reported Clinical Symptoms and an Endoscopic Score Correlates Well with Health-Related Quality of Life in Patients with Ulcerative Colitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Symptoms and Patient-Reported Outcomes
2.3. Endoscopic Inflammation
2.4. Disease Activity According to the Symptoms and MES
2.5. Statistical Analysis
3. Results
3.1. Correlations of Symptoms, MES, and PROs
3.2. Correlations of SIBDQ and Various PROs
3.3. Association between Disease Activity and PROs
4. Discussion
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variables | N = 90 |
---|---|
Median age, years (IQR) | 45 (32–56) |
Males, n (%) | 41 (46%) |
White race, n (%) | 86 (96%) |
Non-Hispanic ethnicity, n (%) | 90 (100%) |
Mean body mass index, kg/m2 (SD) | 27.9 (6.8) |
Smoking status, n (%) | |
Never-smoker | 60 (67%) |
Ex-smoker | 28 (31%) |
Current smoker | 2 (2%) |
Other comorbid diseases, n (%) | |
Diabetes mellitus | 4 (4%) |
Hypertension | 5 (6%) |
None | 81 (90%) |
Median UC duration, years (IQR) | 9.9 (4.2–17.2) |
UC location, n (%) | |
Proctitis/proctosigmoiditis | 10 (11%) |
Left-sided colitis | 25 (28%) |
Extensive colitis | 55 (61%) |
UC current medication, n (%) | |
5-Aminosalicylates | 38 (42%) |
Immunomodulators | 25 (28%) |
Systemic corticosteroids | 16 (18%) |
Biologic agents | 40 (44%) |
None | 10 (11%) |
ClinPRO2 | |
Rectal bleeding, n (%) | |
Score 0: no blood seen | 46 (51%) |
Score 1: streaks of blood less than half the time | 20 (22%) |
Score 2: obvious blood most of the time | 17 (19%) |
Score 3: blood passes alone | 7 (8%) |
Stool frequency, n (%) | |
Score 0: normal | 27 (30%) |
Score 1: 1–2 per day more than normal | 17 (19%) |
Score 2: 3–4 per day more than normal | 14 (16%) |
Score 3: ≥5 per day more than normal | 32 (35%) |
Mayo endoscopic subscore, n (%) | |
Score 0: normal | 10 (11%) |
Score 1: erythema, decreased vascular pattern | 26 (29%) |
Score 2: marked erythema, absent vascular pattern, friability, erosion | 18 (20%) |
Score 3: spontaneous bleedings, ulceration | 36 (40%) |
Median SIBDQ (IQR) | 48.5 (34–59) |
Median EQ5D3L-TTO (IQR) | 0.827 (0.778–1) |
Median WPAI (IQR) | |
% overall work impairment | 36 (0–80) |
Median FACIT-F (IQR) | 33.1 (13.1) |
Median HADS-Depression (IQR) | 4 (1–7) |
Median HADS-Anxiety (IQR) | 5 (3–9) |
Outcomes | SIBDQ | EQ5D3L | WPAI | FACIT-F | HADS Depression | HADS Anxiety |
---|---|---|---|---|---|---|
MES | −0.47 * | −0.31 * | 0.44 * | −0.34 * | 0.22 † | 0.22 † |
ClinPRO2 | −0.73 * | −0.53 * | 0.63 * | −0.62 * | 0.50 * | 0.30 * |
Combination of ClinPRO2 and MES | −0.70 * | −0.51 * | 0.62 * | −0.58 * | 0.45* | 0.30 * |
SIBDQ | - | 0.67 * | −0.80 * | 0.86 * | −0.75 * | −0.53 * |
EQ5D3L | - | - | −0.48 * | 0.69 * | −0.67 * | −0.30 * |
WPAI | - | - | - | −0.68 * | 0.51 * | 0.37 * |
FACIT-F | - | - | - | - | −0.84 * | −0.44 * |
UC Patients Categorized by ClinPRO2 and Mucosal Healing | p-Value | |||
---|---|---|---|---|
No Symptoms (n = 25) | Symptoms Present but MH (n = 15) | Symptoms Present and no MH (n = 50) | ||
Median age, years (IQR) | 45 (32–63) | 49 (35–64) | 46 (31–54) | 0.38 |
Male, n (%) | 9 (36%) | 7 (47%) | 25 (50%) | 0.24 |
Extensive UC, n (%) | 14 (56%) | 11 (73%) | 30 (60%) | 0.78 |
Current medication, n (%) | ||||
5-ASA use | 11 (44%) | 8 (53%) | 19 (38%) | 0.56 |
Systemic corticosteroids | 1 (4%) | 2 (13%) | 13 (26%) | 0.06 |
Immunosuppressive drugs | 7 (28%) | 6 (40%) | 12 (24%) | 0.48 |
Biologic agents | 10 (40%) | 6 (40%) | 24 (48%) | 0.75 |
Patient-reported outcomes, median (IQR) | ||||
SIBDQ † | 62 (58–64) | 46 (33–56) * | 40.5 (31.8–51) * | < 0.01 |
EQ5D3L † | 1 (0.827–1) | 0.827 (0.761–1) * | 0.816 (0.768–0.856) * | < 0.01 |
WPAI ‡ | 0 (0–0) | 39.4 (16.9–71.7) * | 62.5 (28.0–85.8) * | < 0.01 |
FACIT-F † | 47 (37–48.5) | 24 (19–45) * | 28.5 (18.8–40.3) * | < 0.01 |
HADS-depression ‡ | 2 (1–3) | 6 (2–10) * | 4 (2–7.3) * | < 0.01 |
HADS-anxiety ‡ | 4 (1–5) | 8 (4–10) * | 7 (4–10) * | < 0.01 |
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Aniwan, S.; Bruining, D.H.; Park, S.H.; Al-Bawardy, B.; Kane, S.V.; Coelho Prabhu, N.; Kisiel, J.B.; Raffals, L.E.; Papadakis, K.A.; Pardi, D.S.; et al. The Combination of Patient-Reported Clinical Symptoms and an Endoscopic Score Correlates Well with Health-Related Quality of Life in Patients with Ulcerative Colitis. J. Clin. Med. 2019, 8, 1171. https://doi.org/10.3390/jcm8081171
Aniwan S, Bruining DH, Park SH, Al-Bawardy B, Kane SV, Coelho Prabhu N, Kisiel JB, Raffals LE, Papadakis KA, Pardi DS, et al. The Combination of Patient-Reported Clinical Symptoms and an Endoscopic Score Correlates Well with Health-Related Quality of Life in Patients with Ulcerative Colitis. Journal of Clinical Medicine. 2019; 8(8):1171. https://doi.org/10.3390/jcm8081171
Chicago/Turabian StyleAniwan, Satimai, David H. Bruining, Sang Hyoung Park, Badr Al-Bawardy, Sunanda V. Kane, Nayantara Coelho Prabhu, John B. Kisiel, Laura E. Raffals, Konstantinos A. Papadakis, Darrell S. Pardi, and et al. 2019. "The Combination of Patient-Reported Clinical Symptoms and an Endoscopic Score Correlates Well with Health-Related Quality of Life in Patients with Ulcerative Colitis" Journal of Clinical Medicine 8, no. 8: 1171. https://doi.org/10.3390/jcm8081171