Abstract:
Background
Patient reported-outcomes [PROs] are a major therapeutic goal in inflammatory bowel disease [IBD]. The study objective was to investigate the burden of IBD and unmet medical need in patients who receive biologic therapy in Greece.
Between October 2023 and January 2024, adult patients who were members of Hellenic Society of Crohn’s disease’s (CD) and Ulcerative Colitis’ (UC) patients (HELLESCC) filled out a structured self-questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, IBD medications, and PROs (Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment-Specific Health Problem [WPAI-SHP], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction and treatment adherence).
Datasets were obtained from 287 IBD patients (median age 42 years, proportion of females 57.8%, median BMI 26, proportion of current smokers 35.2%, median age at diagnosis and disease duration 30 and 10 years, respectively). According to disease activity scores, 42.9% were in remission, 26.8% had mild disease, and 30.3% had moderate/severe disease. Around 76% of patients reported moderately [SIBDQ 45–59: 31.8%] to severely [SIBDQ <45: 44.5%] impaired quality of life (QoL) (30% of them were in remission). One-fifth reported work productivity loss and 30% reported activity impairment (severe work and activity impairment [>50%] in 30.2% and 42.9% of patients respectively). Around half of patients reported moderate to severe depressive symptoms [PHQ-9≥10: 48.1%]. The 39.1% of patients were “not at all”, “little” or “quite” satisfied by their biologic treatment, with the main reason of dissatisfaction being the “fatigue is increasing”. Nine out of ten patients (89.1%) reported that they follow their biologic treatment regularly. Statistically significant relationships were found between PROs but not between disease types [CD or UC] or therapeutic classes (tumor necrosis factor-α antagonists, anti-integrin agents, and interleukin-12/23 antagonists).
Despite the use of biologic therapies, the disease burden is very high in IBD, with poor QoL as well as increased work impairment, depression, and disease activity in Greek patients. Marked treatment dissatisfaction was reported by four out of ten patients.