Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

doi:10.3748/wjg.v25.i38.5862

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Oct 14, 2019; 25(38): 5862-5882
Published online Oct 14, 2019. doi: 10.3748/wjg.v25.i38.5862

Table 6 Treatment for inflammatory bowel diseases at baseline and changes during the previous 3 years

	CD				UC
	Total	Moderate to severe activity	No or mild activity	P value	Total	Moderate to severe activity	No or mild activity	P value
n	264	118	146		143	36	107
IBD treatment at baseline
Treated patients	251 (95.1)	111 (94.1)	140 (95.9)		129 (90.2)	32 (88.9)	97 (90.7)
IBD medicines/pt, median [range]²	2.0 [1-7]]	2.0 [1.6]	2.0 [1-7]		2.0 [1-6]	3 [1-6]	2 [1-5]
Main IBD therapy³
5-ASA compounds	39 (15.5)	20 (18.0)	19 (13.6)		100 (77.5)	27 (84.4)	73 (75.3)
Biologic therapy	189 (75.3)	79 (71.2)	110 (78.6)		41 (31.8)	11 (34.4)	30 (30.9)
Immunosup-pressants	178 (70.9)	80 (72.1)	98 (70.0)		63 (48.8)	17 (53.1)	46 (47.4)
Any corticosteroid	30 (12.0)	17 (15.3)	14 (10.0)		26 (20.2)	13 (40.6)	13 (13.4)
Any antibiotic	14 (5.6)	11 (9.9)	3 (2.1)		7 (5.4)	5 (15.6)	2 (2.1)
Changes to IBD treatment
Treatment changes /pt, median [range]²	1 [0-23]	1 [0-23]	1 [0-9]	0.526	2 [0-15]	1 [0-15]	2 [0-10]	0.226
At least one change on IBD treatment²	186 (70.7)	81 (69.2)	105 (71.9)	0.634¹	111 (77.6)	24 (66.7)	87 (81.3)	0.068¹
Type of change²
Ongoing or beginning	437 (35.6)	190 (31.6)	247 (39.5)		265 (36.1)	75 (38.7)	190 (35.2)
Dose change	256 (20.9)	128 (21.3)	128 (20.4)		189 (25.7)	39 (20.1)	150 (27.8)
Discontinued	534 (43.5)	283 (47.1)	251 (40.1)		280 (38.1)	80 (41.2)	200 (37.0)
Dose change by main IBD therapy	146	71	75		128	31	97
5-ASA compounds	19 (13.0)	5 (7.0)	14 (18.7)		89 (69.5)	20 (64.5)	69 (71.1)
Biologic therapy	53 (36.3)	27 (38.0)	26 (34.7)		12 (9.4)	5 (16.1)	7 (7.2)
Immunosup-pressants	74 (50.7)	39 (54.9)	35 (46.7)		27 (21.1)	6 (19.4)	21 (21.6)
Discontinua-tion by main IBD therapy	226	123	103		128	36	92
5-ASA compounds	64 (28.3)	33 (26.8)	31 (30.1)		82 (64.1)	20 (55.6)	62 (67.4)
Biologic therapy	72 (31.9)	44 (35.8)	28 (27.2)		11 (8.6)	8 (22.2)	3 (3.3)
Immunosup-pressants	90 (39.8)	46 (37.4)	44 (42.7)		35 (27.3)	8 (22.2)	27 (29.3)
Reason for dose change of biologics [frequency ≥ 5%]⁴
Adverse reaction	0 (0.0)	0 (0.0)	0 (0.0)		2 (16.7)	2 (40.0)	0 (0.0)
Patient decision/ad-herence	1 (1.9)	1 (3.7)	0 (0.0)		2 (16.7)	0 (0.0)	2 (28.6)
Poor effectiveness	22 (41.5)	12 (44.4)	10 (38.5)		3 (25.0)	1 (20.0)	2 (28.6)
Remission	5 (9.4)	2 (7.4)	3 (11.5)		0 (0.0)	0 (0.0)	0 (0.0)
Serum level of biologic drug	2 (3.8)	1 (3.7)	1 (3.8)		3 (25.0)	1 (20.0)	2 (28.6)
Reason for discontinua-tion of biol-ogics [frequency ≥ 5%]
Adverse reaction	21 (29.2)	13 (29.5)	8 (28.6)		3 (27.5)	2 (25.0)	1 (33.3)
Contraindica-tion	6 (8.3)	5 (11.4)	1 (3.6)		1 (9.1)	0 (0.0)	1 (33.3)
Patient decision/ad-herence	5 (6.9)	4 (9.1)	1 (3.6)		2 (18.2)	1 (12.5)	1 (33.3)
Poor effectiveness	6 (8.3)	2 (4.5)	4 (14.3)		0 (0.0)	0 (0.0)	0 (0.0)

All P-values from Mann-Whitney U test, except

¹Chi-square test. Data are shown as n (%), except otherwise mentioned.

²Including antibiotics and corticosteroids.

³Patients with at least one of the main IBD drug classes, excluding antibiotics, corticosteroids and other medications.

⁴More than one possible reason for dose change. CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; pt: Patient.

Citation: Parra RS, Chebli JM, Amarante HM, Flores C, Parente JM, Ramos O, Fernandes M, Rocha JJ, Feitosa MR, Feres O, Scotton AS, Nones RB, Lima MM, Zaltman C, Goncalves CD, Guimaraes IM, Santana GO, Sassaki LY, Hossne RS, Bafutto M, Junior RL, Faria MA, Miszputen SJ, Gomes TN, Catapani WR, Faria AA, Souza SC, Caratin RF, Senra JT, Ferrari ML. Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil. World J Gastroenterol 2019; 25(38): 5862-5882
URL: https://www.wjgnet.com/1007-9327/full/v25/i38/5862.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i38.5862