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

Table 1 Sociodemographic characteristics and clinical features of included patients

	CD patients (n = 264)	UC patients (n = 143)
Age (yr), mean ± SD	42.9 ± 13.0	45.9 ± 13.8
Female	143 (54.2)	81 (56.6)
Educational level
Primary school	55 (26.6)	38 (38.8)
Secondary school	83 (40.1)	37 (37.7)
Higher education	69 (33.3)	23 (23.5)
Missing	57	45
Professional situation
Employed	101 (44.3)	53 (42.7)
Unemployed	61 (26.8)	33 (26.6)
Student	10 (4.4)	5 (4.0)
Retired	30 (13.2)	15 (12.1)
Other	26 (11.4)	18 (14.5)
Missing	36	19
Current smokers1	24 (9.9)	3 (2.3)
Missing	22	11
Time since IBD diagnosis (yr), median [range]	10.0 [0.5-45.0]	10.0 [0.5-31.0]
Time since moderate-to-severe diagnosis (yr), median [range]	6.0 [0.5-30.0]	5.0 [0.5-25.0]
Steroid response2
Steroid-dependent	31 (14.8)	23 (19.3)
Steroid-refractory	16 (7.7)	11 (9.2)
Not applicable (no previous use)	87 (41.6)	36 (30.3)
Unknown	75 (35.9)	49 (41.2)
Missing	55	24
Any extraintestinal manifestations	54 (37.8)	30 (38.0)
Family IBD history	33 (12.5)	15 (10.5)
Moderately to severely active disease at baseline3	118 (44.7)	36 (25.2)
UC location [Montreal classification]
E1- distal UC	--	43 (30.1)
E2- left-sided	--	26 (18.2)
E3- pancolitis	--	74 (51.7)
UC severity [Montreal classification]
S0- asymptomatic	--	57 (39.9)
S1- mild UC	--	32 (22.4)
S2- moderate UC	--	40 (28.0)
S3- severe UC	--	14 (9.8)
CD location [Montreal classification]
L1- ileal	67 (25.4)	--
L2- colonic	42 (15.9)	--
L3- ileocolonic	150 (56.8)	--
L4- upper GI tract disease	17 (6.4)	--
CD behavior [Montreal classification]
B1- Nonstricturing/nonpenetrating	58 (22.0)	--
B2- Stricturing	110 (41.7)	--
B3- Penetrating	91 (34.5)	--
Perianal disease	105 (39.8)	--
Ileal surface involved ≥ 1 m [n = 201]	38 (18.9)	--

Data are shown as n (%), except where otherwise mentioned.

¹Patients were smoking at baseline and has smoked 100 cigarettes in his/her lifetime.

²Steroid-dependent disease: patients who either (1) Were unable to reduce steroids below the equivalent of prednisolone 10 mg/d within 3 mo of starting steroids, without recurrent disease, or (2) Had a relapse within 3 mo of stopping glucocorticoids. Steroid-refractory disease: active disease despite prednisolone up to 0.75 mg/kg/d over 4 wk.

³Moderate-to-severe activity at baseline was defined as pMayo ≥ 5 (UC) and having HBI ≥ 8 or CDAI ≥ 220 (CD). IBD: Inflammatory bowel disease; UC: Ulcerative colitis; CD: Crohn’s disease.

Table 2 Quality of life according to type of inflammatory bowel disease and disease activity

	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	263	118	145		143	36	107
Missing value1	1	0	1		0	0	0
SF-36 scores
Physical component	46.6 [20.6-68.6]	44.0 [20.6-62.3]	48.6 [27.1-68.6]	< 0.001	44.7 [23.4-63.8]	40.5 [23.4-58.8]	46.2 [23.9-63.8]	0.007
Physical functioning	75.0 [10.0-100.0]	70.0 [10.0-100.0]	85.0 [15.0-100.0]	< 0.001	70.0 [0.0-100.0]	55.0 [0.0-100.0]	77.5 [0.0-100.0]	0.043
Physical role	68.8 [0.0-100.0]	50.0 [0.0-100.0]	75.0 [0.0-100.0]	< 0.001	59.4 [0.0-100.0]	40.6 [0.0-100.0]	75.0 [0.0-100.0]	< 0.001
Body pain	52.0 [0.0-100.0]	51.0 [0.0-100.0]	62.0 [10.0-100.0]	< 0.001	51.0 [0.0-100.0]	31.0 [0.0-100.0]	60.5 [0.0-100.0]	0.001
General health	52.0 [0.0-100.0]	46.0 [0.0-100.0]	57.0 [10.0-100.0]	< 0.001	51.0 [5.0-100.0]	31.0 [5.0-100.0]	55.0 [5.0-100.0]	< 0.001
Mental component	45.2 [5.8-67.2]	42.3 [14.0-63.6]	48.4 [5.8-67.2]	0.022	44.2 [7.9-65.0]	35.0 [7.9-64.1]	46.6 [7.9-65.0]	< 0.001
Vitality	56.3 [0.0-100.0]	50.0 [6.3-100.0]	56.3 [0.0-100.0]	0.074	50.0 [0.0-100.0]	37.5 [0.0-93.8]	56.3 [0.0-100.0]	0.002
Social role functioning	62.5 [0.0-100.0]	50.0 [0.0-100.0]	75.0 [0.0-100.0]	0.002	62.5 [0.0-100.0]	50.0 [0.0-100.0]	62.5 [0.0-100.0]	0.002
Emotional role	75.0 [0.0-100.0]	66.7 [0.0-100.0]	79.2 [0.0-100.0]	0.012	75.0 [0.0-100.0]	45.8 [0.0-100.0]	75.0 [0.0-100.0]	0.002
Mental health	65.0 [0.0-100.0]	55.0 [0.0-100.0]	72.5 [0.0-100.0]	0.008	60.0 [0.0-100.0]	45.0 [5.0-100.0]	70.0 [0.0-100.0]	< 0.001
EQ-VAS (cm)	80.0 [5.0-100.0]	70.0 [5.0-100.0]	80.0 [15.0-100.0]	0.003	70.0 [0.0-100.0]	50.0 [0.0-100.0]	80.0 [0.0-100.0]	< 0.001
EQ-5D [no problems], n (%)
Mobility	193 (73.4)	80 (67.8)	113 (77.9)	0.0802	85 (59.9)	17 (47.2)	68 (64.2)	0.0732
Self-care	225 (85.6)	95 (80.5)	130 (89.7)	0.0522	120 (84.5)	29 (80.6)	91 (85.8)	0.4482
Usual activities	125 (47.5)	47 (39.8)	78 (53.8)	0.1582	66 (46.8)	10 (27.8)	56 (53.3)	0.0092
Pain/disco-mfort	87 (33.1)	31 (26.3)	56 (38.6)	0.0362	30 (21.3)	3 (8.3)	27 (25.7)	0.0122
Anxiety/de-pression	95 (36.1)	31 (26.3)	64 (44.1)	0.0392	51 (36.2)	9 (25.0)	42 (40.0)	0.1142
IBDQ score	164.0 [50.0-224.0]	153.5 [50.0-222.0]	178.0 [57.0-224.0]	< 0.001	165.0 [47.0-224.0]	106.0 [48.0-217.0]	178.5 [47.0-224.0]	< 0.001
Bowel symptoms	5.7 [1.4-7.0]	5.3 [1.4-7.0]	6.0 [1.8-7.0]	< 0.001	5.4 [1.3-7.0]	3.7 [1.3-7.0]	6.1 [1.5-7.0]	< 0.001
Emotional health	4.8 [1.2-7.0]	4.4 [1.2-6.9]	5.3 [1.5-7.0]	0.001	4.9 [1.0-7.0]	2.9 [1.2-6.6]	5.3 [1.0-7.0]	< 0.001
Systemic symptoms	4.8 [1.0-7.0]	4.4 [1.2-7.0]	5.0 [1.0-7.0]	< 0.001	4.8 [1.0-7.0]	3.2 [1.0-7.0]	5.2 [1.0-7.0]	< 0.001
Social function	5.4 [1.2-7.0]	5.0 [1.2-7.0]	5.8 [1.4-7.0]	< 0.001	5.4 [1.2-7.0]	3.8 [1.2-7.0]	6.0 [1.2-7.0]	< 0.001
WPAI scores
% TWPI	20.0 [0.0-100.0]	30.0 [0.0-100.0]	19.7 [0.0-100.0]	0.053	5.0 [0.0-100.0]	34.8 [0.0-100.0]	0.0 [0.0-100.0]	0.082
% work time missed	0.0 [0.0-100.0]	4.7 [0.0-100.0]	0.0 [0.0-64.0]	0.009	0.0 [0.0-100.0]	5.9 [0.0-100.0]	0.0 [0.0-100.0]	0.287
% impairment while working	10.0 [0.0-100.0]	10.0 [0.0-80.0]	10.0 [0.0-100.0]	0.336	0.0 [0.0-80.0]	20.0 [0.0-80.0]	0.0 [0.0-80.0]	0.08
% TAI	30.0 [0.0-100.0]	50.0 [0.0-100.0]	20.0 [0.0-100.0]	< 0.001	30.0 [0.0-100.0]	75.0 [0.0-100.0]	10.0 [0.0-100.0]	< 0.001

¹The missing data is due to a patient who has not completed SF-36 at Day 1. All p-values from Mann-Whitney U test, except

²Chi-square test. Data are shown as median [range], except otherwise mentioned. CD: Crohn’s disease; UC: Ulcerative colitis. SF-36: Short-form 36; EQ-5D: Euro quality of life – 5 dimensions; EQ-VAS: EQ-5D visual analog scale. IBDQ: Inflammatory bowel disease questionnaire. WPAI: Work Productivity and Activity Impairment Questionnaire. TWPI: Total work productivity impairment; TAI: Total activity impairment.

Table 3 Quality of Life scores by sociodemographic and clinical characteristics and by type of inflammatory bowel disease

	CD								UC
	SF-36 mental com-pon-ent		SF-36 phys-ical com-pon-ent		EQ-VAS		IBDQ score		SF-36 mental com-pon-ent		SF-36 phys-ical com-pon-ent		EQ-VAS		IBDQ score
	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value
Age (years)		0.018		0.895		0.514		0.002		0.1553		0.263		0.534		0.8473
18-39	44.8 ± 13.0		43.1 ± 10.5		72.4 ± 20.3		158.9 ± 41.0		46.5 ± 10.0		46.0 ± 10.0		67.7 ± 22.2		151.6 ± 43.8
40-59	41.9 ± 12.9		43.5 ± 14.3		73.4 ± 20.5		151.0 ± 43.4		43.1 ± 10.1		45.0 ± 9.8		65.5 ± 25.6		153.0 ± 54.8
≥60	48.8 ± 9.4		42.0 ± 16.8		76.1 ± 19.8		178.7 ± 30.1		46.1 ± 9.7		48.2 ± 7.9		69.9 ± 30.5		157.2 ± 46.8
Gen-der		< 0.0011		0.0271		0.0041		< 0.0011		0.0041		0.0321		0.0421		< 0.001
Male	48.0 ± 11.3		45.9 ± 13.6		77.5 ± 18.0		169.5 ± 38.0		47.5 ± 9.7		47.3 ± 8.9		72.4 ± 22.0		169.7 ± 43.3
Fem-ale	41.2 ± 12.9		41.0 ± 13.1		69.8 ± 21.4		149.9 ± 42.1		42.7 ± 9.9		44.8 ± 10.0		62.8 ± 26.8		140.7 ± 50.8
Prof-essi-onal situa-tion		0.002		0.030 2		0.003		< 0.001		< 0.0012		< 0.001		0.130		0.001
Emp-loyed	47.5 ± 11.5		47.6 ± 11.4		78.1 ± 19.4		168.1 ± 40.4		49.4 ± 8.9		49.2 ± 8.0		73.2± 23.2		175.7 ± 39.3
Une-mplo-yed	40.0 ± 14.0		39.2 ± 13.5		67.6 ± 21.2		145.3 ± 40.6		41.2 ± 9.8		42.9 ± 9.3		64.9± 25.9		135.8 ± 51.5
Stu-dent	43.0 ± 16.0		44.2 ± 11.2		75.5 ± 18.6		172.6 ± 42.8		42.0 ± 12.6		54.2 ± 9.8		61.6± 15.2		139.6 ± 35.3
Reti-red	46.4 ± 8.2		39.3 ± 18.3		75.2 ± 15.8		165.2 ± 33.5		41.7 ± 10.7		45.4 ± 7.8		55.2± 31.4		135.7 ± 53.3
Other	39.0 ± 14.0		40.3 ± 12.7		64.8 ± 23.4		135.5 ± 50.7		41.2 ± 8.9		39.8 ± 10.2		62.2± 24.3		138.4 ± 52.2
Edu-cati-onal level		0.802		0.176 2		0.990		0.398 2		0.122 2		0.0282		0.510		0.185
Pri-mary school	43.7 ± 11.4		43.7 ± 11.4		73.2 ± 20.8		156.3 ± 40.8		44.0 ± 9.3		44.0 ± 9.3		66.6 ± 27.9		143.0 ± 56.8
Seco-ndary school	43.0 ± 13.3		43.0 ± 13.3		73.1 ± 20.7		152.9 ± 44.9		45.3 ± 9.9		45.3 ± 9.9		66.4 ± 25.8		160.0 ± 47.6
Hig-her educ-ation	44.1 ± 13.2		44.1 ± 13.2		72.8 ± 20.1		162.2 ± 39.1		48.4 ± 8.9		48.4 ± 8.9		76.0 ± 6.5		171.4 ± 42.3
Inc-ome		0.112		0.0072		0.547		0.0872		< 0.001		0.0952		0.0702		0.0022
> 3x MW	46.2 ± 11.9		47.7 ± 9.2		74.6 ± 21.4		169.2 ± 39.6		52.3 ± 9.4		49.3 ± 8.0		75.3 ± 16.2		179.0 ± 39.7
> 1x – 3x MW	43.6 ± 11.8		46.1 ± 14.0		73.9 ± 20.2		157.6 ± 40.2		44.1 ± 9.0		46.2 ± 9.1		69.8 ± 24.6		158.7 ± 49.3
< 1x MW	40.4 ± 13.6		36.2 ± 13.3		70.9 ± 20.8		149.4 ± 43.9		39.2 ± 10.0		45.9 ± 9.8		58.8 ± 26.2		124.0 ± 50.7
Any EIM		0.4703		0.9243		0.6871		0.750 1		0.3433		0.2423		0.6011		0.7011
Yes	44.8 ± 13.0		42.0 ± 14.9		70.7 ± 19.6		158.0 ± 42.2		42.6 ± 8.6		44.4 ± 7.9		69.6 ± 19.0		149.6 ± 48.5
No	43.2 ± 11.9		42.3 ± 12.9		71.3 ± 22.0		161.0 ± 40.7		44.7 ± 10.4		46.2 ± 10.4		64.1 ± 27.8		152.2 ± 49.8

All P-values from Kruskal-Wallis test, except

¹Mann-Whitney U test,

²ANOVA test, and

³t-test. EIM: Extraintestinal Manifestations; MW: Minimum wage.

Table 4 Work productivity and activity impairment scores by sociodemographic and clinical characteristics and by type of inflammatory bowel diseases

	CD								UC
	% TWPI		% work time missed		% impairment while working		% TAI		% TWPI		% work time missed		% impairment while working		% TAI
	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value	mean ± SD	P value
Age (yr)		0.522		0.208		0.541		0.007		0.803		0.453		0.929		0.433
18-39	31.8 ± 32.4		13.8 ± 23.6		23.3 ± 26.4		36.3 ± 34.1		28.5 ± 34.6		13.7 ± 27.1		19.6 ± 28.0		44.3 ± 36.1
40-59	35.2 ± 35.1		12.9 ± 25.8		27.4 ± 30.8		41.2 ± 34.2		23.7 ± 33.6		11.7 ± 29.3		15.9 ± 25.0		37.6 ± 37.5
≥ 60	19.6 ± 25.8		4.2 ± 11.8		15.6 ± 21.3		21.2 ± 25.4		19.6 ± 29.4		3.6 ± 6.2		18.0 ± 26.8		37.4 ± 40.9
Gen-der		0.186 1		0.9141		0.148 1		0.0141		0.4651		0.6491		0.0921		0.0431
Male	27.8 ± 30.5		13.0 ± 24.4		20.0 ± 23.4		30.4 ± 32.6		22.5 ± 32.0		13.4 ± 27.9		12.4 ± 21.9		31.8 ± 36.2
Fem-ale	37.6 ± 35.5		12.2 ± 23.2		29.6 ± 32.0		40.3 ± 33.6		29.5 ± 35.1		9.3 ± 25.2		24.6 ± 29.8		45.9 ± 37.5
Prof-essi-onal situa-tion		0.198		0.753		0.078		< 0.001		-		-		-		0.001
Emp-loyed	30.1 ± 31.4		11.0 ± 20.5		23.0 ± 27.8		24.2 ± 30.6		23.4 ± 31.5		9.4 ± 23.8		17.7 ± 26.2		23.7 ± 30.7
Une-mpl-oyed	54.7 ± 18.0		5.4 ± 6.7		56.0 ± 16.7		49.8 ± 33.3		-		-		-		52.4 ± 39.1
Stu-dent	-		-		-		23.0 ± 27.9		-		-		-		56.0 ± 24.1
Reti-red	62.5 ± 17.7		25.0 ± 35.3		33.3 ± 28.9		32.3 ± 32.2		0.0		0.0		0.0		48.7 ± 43.4
Other	45.0 ± 63.6		33.3 ± 47.1		35.0 ± 49.5		56.2 ± 29.1		-		-		-		51.1 ± 36.3
Edu-cati-onal level		0.608		0.591		0.455		0.114		0.331		0.571		0.186		0.252
Pri-mary school	37.4 ± 30.8		12.3 ± 15.6		28.6 ± 29.0		39.6 ± 34.9		15.7 ± 29.1		8.0 ± 17.7		8.0 ± 19.3		39.2 ± 40.8
Sec-onda-ry school	37.1 ± 33.4		9.0 ± 17.7		29.1 ± 30.5		43.6 ± 36.6		26.3 ± 32.5		10.1 ± 28.6		21.2 ± 26.0		42.2 ± 37.5
Hig-her educ-ation	30.0 ± 33.6		16.0 ± 26.6		20.5 ± 25.6		29.1 ± 28.4		10.6 ± 19.4		1.1 ± 2.7		10.0 ± 18.3		25.7 ± 31.7
Inc-ome		0.293		0.708		0.042		0.079		0.341		0.648		0.453		0.032
> 3x MW	33.0 ± 35.5		13.4 ± 25.6		25.8 ± 30.2		25.9 ± 30.8		23.0 ± 33.0		9.3 ± 27.5		22.0 ± 28.6		25.8 ± 36.7
> 1x – 3x MW	28.0 ± 28.5		13.9 ± 23.8		16.8 ± 20.1		38.6 ± 34.2		27.6 ± 27.4		7.1 ± 16.4		16.7 ± 22.7		38.9 ± 36.8
< 1x MW	60.0 ± 10.8		7.3 ± 8.9		50.0 ± 24.5		42.3 ± 35.1		0.0 ± 0.0		0.0 ± 0.0		0.0 ± 0.0		56.8 ± 35.8
Any EIM		0.0051		0.0041		0.199 1		0.6561		0.3451		0.8241		0.214 1		0.8961
Yes	53.9 ± 33.4		23.3 ± 28.2		32.9 ± 31.8		37.2 ± 32.1		28.5 ± 31.2		1.8 ± 4.4		27.3 ± 31.0		37.0 ± 36.4
No	23.5 ± 31.9		6.2 ± 15.4		21.0 ± 28.4		35.1 ± 33.8		19.0 ± 31.6		9.4 ± 26.6		13.7 ± 23.9		36.7 ± 38.4

All P-values from Kruskal-Wallis test, except

¹Mann-Whitney U test. EIM: Extraintestinal manifestations; MW: Minimum wage; TWPI: Total work productivity impairment; TAI: Total activity impairment.

Table 5 Utilization of healthcare resources during the retrospective 3-year period

	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 surgeries
At least one IBD surgery	67 (25.4)	32 (27.1)	35 (24.0)	0.559 1	4 (2.8)	1 (2.8)	3 (2.8)	--
Surgeries, n	108	45	63		7	2	5
Surgeries/pt, median [range]	1.0 [1-5]	1.0 [1-4]	2 [1-5]	0.074	2.0 [1-2]	2	2.0 [1-2]	--
More than one IBD surgery	28 (41.8)	10 (31.2)	18 (51.5)		3 (75.0)	1 (100.0)	2 (66.7)
Type [frequency ≥ 5%]
Partial colectomy	13 (12.0)	5 (11.1)	8 (12.7)		0 (0.0)	0 (0.0)	0 (0.0)
Total colectomy	1 (0.9)	0 (0.0)	1 (1.6)		2 (28.6)	1 (50.0)	1 (20.0)
Drainage of anorectal abscess	6 (5.6)	3 (6.7)	3 (4.8)		0 (0.0)	0 (0.0)	0 (0.0)
Fistulectomy	22 (20.4)	9 (20.0)	13 (20.6)		0 (0.0)	0 (0.0)	0 (0.0)
Enterostomy	13 (12.0)	6 (13.3)	7 (11.1)		0 (0.0)	0 (0.0)	0 (0.0)
Enterostomy closure	5 (4.6)	5 (11.1)	0 (0.0)		2 (28.6)	0 (0.0)	2 (40.0)
IBD hospitaliza-tions
At least one IBD hospitaliza-tion	101 (38.3)	51 (43.2)	50 (34.2)	0.136 1	28 (19.6)	11 (30.6)	17 (15.9)	0.055 1
Hospitaliza-tions, n	168	93	75		43	18	25
Hospitaliza-tions/pt, median [range]	1.0 [1-5]	2.0 [1-4]	1.0 [1-5]	0.031	1.0 [1-5]	1.0 [1-5]	1.0 [1-3]	0.978
More than one hospitalization	47 (46.5)	29 (56.8)	18 (36.0)		10 (35.7)	4 (36.4)	6 (35.3)
Duration (d), median [range]	6 [1-98]	5 [0-76]	4.5 [0-97]		4 [1-737]	2.5 [0-20]	5 [0-737]
IBD medical appointments
At least one IBD consultation	263 (99.6)	117 (99.2)	146 (100.0)		143 (100.0)	36 (100.0)	107 (100.0)
Consultations, n	3192	1466	1726		1541	423	1118
Consultations /pt, median [range]	11.0 [1-45]	12.0 [1-45]	11.0 [1-35]	0.801	10.0 [1-39]	9.5 [1-39]	10.0 [2-30]	0.896
More than 20 consultations	27 (10.3)	15 (12.8)	12 (8.2)		9 (6.3)	4 (11.1)	5 (4.7)
Type
IBD specialist	2989 (93.6)	1356 (92.4)	1633 (94.6)		1426 (92.5)	394 (93.1)	1032 (92.3)
Emergency	43 (1.3)	25 (1.7)	18 (1.0)		34 (2.2)	20 (4.7)	14 (1.3)
Other specialist	160 (5.0)	85 (5.8)	75 (4.3)		81 (5.3)	9 (2.1)	72 (6.4)
Consultations with registered score
HBI	11 (0.3)	1 (0.1)	10 (0.6)		--	--	--
CDAI	103 (3.2)	54 (3.7)	49 (2.8)		--	--	--
Other CD scores	30 (0.9)	21 (1.4)	9 (0.5)		--	--	--
pMayo score	--	--	--		95 (6.2)	12 (2.8)	83 (7.4)
Consultations with change of IBD treatment	522 (16.4)	269 (18.3)	253 (14.7)	0.005 1	353 (22.9)	86 (20.3)	267 (23.9)	0.139 1
IBD imaging and laboratory testing
At least one IBD test	260 (98.5)	116 (98.3)	144 (98.6)	--	141 (98.6)	36 (100.0)	105 (98.1)	--
IBD tests, n	5674	2722	2952		2509	643	1866
Tests/pt, median [range]	19.0 [1-143]	20.0 [1-143]	16.0 [1-94]	0.372	15.0 [1-82]	14.5 [2-82]	16 [1-75]	0.767
More than 20 tests	118 (45.4)	56 (48.3)	62 (43.1)		57 (40.4)	15 (41.7)	42 (40.0)
Type [frequency ≥ 5%]
Complete blood cell count	2317 (40.8)	1077 (39.6)	1240 (42.0)		973 (38.8)	250 (38.9)	723 (38.7)
C-reactive protein	1773 (31.2)	837 (30.7)	936 (31.7)		748 (29.8)	214 (33.3)	534 (28.6)
Serum albumin	647 (11.4)	346 (12.7)	301 (10.2)		356 (14.2)	59 (9.2)	297 (15.9)
Colonoscopy	346 (6.1)	183 (6.7)	163 (5.5)		228 (9.1)	57 (8.9)	171 (9.2)

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

¹Chi-square test. Data are shown as n (%), except otherwise mentioned. CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; pt: Patient.

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.