Abstract
Abstract Background Crohn’s disease (CD) and Ulcerative colitis (UC) affect patients’ physical and emotional well-being, posing substantial challenges to daily functioning.1 The CONFIDE study explored patients’ perspectives on the experiences and impact of CD and UC-related symptoms in the US, Europe (France, Germany, Italy, Spain, and UK), and Japan. Here, we assessed the impact of moderate-to-severe CD or UC on self-reported health status using the EQ-5D-5L questionnaire. Methods Online, quantitative, cross-sectional surveys were conducted among patients with moderate-to-severe CD or UC, defined by criteria based on previous treatment, steroid use, and/or hospitalisation. EQ-5D-5L assesses health status across 5 dimensions—mobility, self-care, usual activities, pain/discomfort, and anxiety/depression—rated from 1 (no problems) to 5 (extreme problems). It also includes a visual analogue scale (VAS) to rate current health from 0 (worst) to 100 (best).2 Descriptive statistics were used to summarise data. Results The analysis included 547 European (males [M]=55%, mean age=38 years [yrs]), 215 US (M=55%, 41 yrs), and 99 Japanese (M=68%, 43 yrs) patients with CD and 556 European (M=57%, 39 yrs), 200 US (M=62%, 40 yrs),and 124 Japanese (M=70%, 49 yrs) patients with UC. Of these, 347 (63%) European, 125 (58%) US, and 86 (87%) Japanese patients with CD, and 301 (54%) European, 153 (77%) US, and 52 (42%) Japanese patients with UC were receiving advanced therapies at data collection. Mean EQ-5D VAS scores were 67.9, 65.0, and 70.7 for European, US, and Japanese patients with CD, and 67.2, 67.0, and 73.1 for those with UC. Similar results were observed in patients receiving advanced therapies (Figure 1). Table 1 summarises health status across EQ-5D-5L dimensions. Of the 5 dimensions, most patients reported pain/discomfort and anxiety/depression. Overall, 81% European, 86% US, and 60% Japanese patients with CD reported ‘slight’ to ‘extreme’ pain/discomfort, while 74% European, 70% US, and 52% Japanese patients reported ‘slight’ to ‘extreme’ anxiety/depression. For UC, the percentages were 80% European, 91% US, and 39% Japanese patients for pain/discomfort, and 72% European, 80% US, and 40% Japanese patients for anxiety/depression. Conclusion Despite receiving advanced therapies, patients with CD or UC in Europe, US, and Japan reported impaired overall health by EQ-5D VAS scores. The European and US cohorts reported worse health, with a higher proportion of patients reporting problems across EQ-5D-5L dimensions than the Japanese cohort, possibly resulting from differences in characteristics of survey respondents, environment (e.g., bathroom access) and healthcare.
Published Version
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