Abstract: OBJECTIVES: Crohn’s disease (CD) requires life-long disease management. The study objective was to investigate the burden of CD and unmet medical need in patients who receive biologic therapy in Greece.
METHODS: Between October 2023 and January 2024, adult patients who were members of Hellenic Society of Crohn’s disease’s and Ulcerative Colitis’ 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 patient-reported outcomes (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).
RESULTS: 201 CD patients receiving a biologic therapy were included in the analysis (median age 42 years, proportion of female patients 59.7%, median BMI 26, proportion of current smokers 41.3%, median age at diagnosis and disease duration 30 and 10 years, respectively). According to the Harvey-Bradshaw Index disease activity groups, 43.3% were in remission, 25.4% had mild disease, and 31.3% had moderate/severe disease. Around 76% of patients reported moderately [SIBDQ 45–59: 29.7%] to severely [SIBDQ <45: 46.6%] impaired quality of life. One-fifth reported work productivity loss and 30% reported activity impairment (severe presenteeism and activity impairment [>50%] in 27.3% and 42.1% of patients respectively). Around half of patients reported moderate to severe depressive symptoms [PHQ-9≥10: 46.9%]. The 41.5% of the patients were “not at all”, “little” or “quite” satisfied by their biologic treatment, with the main reason of dissatisfaction to be the “fatigue is increasing”. Almost all of the patients (95.1%) reported that they follow their biologic treatment regularly. Statistically significant associations were found between PROs and disease activity.
CONCLUSIONS: This real-world analysis suggests that despite increased therapeutic options, Greek CD patients currently being treated with biologics experience high disease burden and continued unmet needs.