N37 Fatigue in Japanese patients with Inflammatory Bowel Disease: a comparative study based on a systematic review

Abstract

Abstract Background Fatigue is a common symptom in patients with inflammatory bowel disease (IBD), often persisting even when the disease is in a state of remission. In addition, it is associated with a diminished quality of life (QOL). However, in Japan, only few studies have focused on fatigue in patients with IBD. The Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) scale has shown reliability and validity in assessing fatigue in patients with IBD, and studies using this scale have been conducted worldwide. In this study, we aimed to examine the current state of fatigue among Japanese patients with IBD using the FACIT-F scale and compare these findings with data from the global studies through a systematic review. Methods Data from 488 patients with IBD treated at a specialized IBD clinic were analysed. Patient characteristics, such as sex, age, and disease duration, along with FACIT-F scores, height, and weight were included as survey items in the questionnaire administered to patients. Data on the disease names and activities, as determined by the Crohn's disease activity index and partial Mayo score, were obtained from medical records. For international comparison, information on age, sex, country, disease duration, body mass index, and disease activity was extracted from each article and listed alongside FACIT-F scores. We conducted a search on PubMed using the search terms ‘inflammatory bowel disease’ OR ‘Crohn's disease’ OR ‘ulcerative colitis’ AND ‘fatigue’ AND ‘FACIT-F’ OR ‘FACIT’ OR ‘FACIT-fatigue’. After applying our predetermined inclusion criteria, we selected eight studies that met our requirements. Results The articles of the systematic review included population sizes ranging from 100 to 1185 patients. Patients’ age varied between the late 30s and early 50s, and the proportion of male patients ranged from 39% to 66%. The duration of disease was approximately 10 years. The proportion of disease names and activities was diverse. The overall mean FACIT-F scores ranged from 38.9 ± 11.0 to 41.6 ± 8.6, while the medians [interquartile ranges] ranged from 30 [22-39] to 41 [35-47]. For each article that presented the FACIT-F scores as means ± standard deviations, the t-tests revealed no statistically significant differences. Overall, the FACIT-F scores were higher (indicating higher QOL) in the remission phase than in the active phase. Additionally, these scores were higher in male patients than in female patients and in patients with ulcerative colitis than in those with Crohn’s disease. These findings were consistent across all countries included in this study. Conclusion The FACIT-F scores of Japanese patients with IBD demonstrated a similar trend to those of other countries.