Improvement in quality of life in inflammatory bowel disease patients treated with advanced therapies: Interim findings from IBD-RESPONSE

Abstract

Background: Crohn's disease (CD) and ulcerative colitis (UC) are typically characterised by diarrhoea, rectal bleeding, abdominal pain, and weight loss. In addition, patients often experience fatigue, joint pain and psychological distress (1). These symptoms can profoundly affect quality of life, and assessment of this is often underrepresented in clinical research. IBD-RESPONSE is a UK-wide multi-centre observational study aiming to develop a predictive algorithm for response to advanced therapies, utilising multi-omics data and extensive clinical metadata (2). Method(s): In IBD-RESPONSE, patient-reported outcome measures (PROMs) were collected at baseline and week 14. PRO-2 was used to calculate clinical response and remission (2). EQ-5D-5L was used to assess health-related quality of life across five domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) from which a utility score was derived, alongside a Visual Analogue Scale (VAS) for perceived health status (3). In this interim analysis of 526 participants, we evaluated changes in quality of life between patients demonstrating treatment response, remission and non-response 14 weeks after commencing an advanced therapy using the Wilcoxon signed-rank test. Result(s): EQ-5D-5L utility scores increased significantly overall, from 0.750 at baseline to 0.854 at week 14 (p < 0.001). Utility scores improved in treatment responders (median change IQR] = 0.1 0.042-0.202]; p < 0.001) and patients in remission (median change IQR] = 0.096 0 - 0.195]; p < 0.001) but did not significantly improve in non-responders (median change IQR] = 0.036 -0.085 - 0.120]; p = 0.076). Similarly, overall VAS scores improved from 50 to 70 (p < 0.001), with a significant increase among responders (median change IQR] = 19 4.5-28]; p < 0.001) and for patients in remission (median change IQR] = 20 6.5-35]; p < 0.001), but not among non-responders (median change IQR] = 1 -10-17]; P = 0.22). Conclusion(s): Treatment response in IBD is associated with meaningful improvements in health-related quality of life. These findings highlight that better disease control not only reduces symptoms but also translates to an improvement in patient wellbeing.