P209 Work productivity and unmet needs of treated ulcerative colitis patients: A Japan National Health and Wellness Survey study

Abstract

Abstract Background Ulcerative colitis (UC), a subset of inflammatory bowel disease (IBD), is a chronic, immune-mediated disease process which causes inflammation and ulceration of the large intestine. In Japan, the annual prevalence of UC in 2014 showed a ten-fold increase in more than 10 years. Despite current treatments, patient-reported disease challenges persist. This study investigated the disease burden and unmet needs of treated UC patients in Japan. Methods This cross-sectional, observational study used existing data from the online, self-administered Japan National Health and Wellness Survey conducted in 2017, 2019, and 2021. Respondents were aged ≥18 years, with self-reported UC and had undergone/were on treatment [5-Aminoslicyclic acid (5-ASA), steroids, immunomodulators (IMs), biologics (Bio)/Janus kinase inhibitors (JAKi), or others]. Data pertaining to demographics and clinical characteristics, medication adherence, health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), and indirect cost were collected and analysed. Results Among 293 treated UC patients in Japan, most were conventional treatment users (84%) and 29% were living with UC for ≥15 years. Despite active treatment, 91% of patients reported UC as bothersome to a certain degree, 35% reported having moderate-to-severe disease severity post-treatment, and 55% reported ≥1 persisting UC symptom. Treated patients reported EuroQoL-5-dimension visual analogue scale scores of 68. Depression and anxiety were reported in ≥35% of patients and majority (68%) of employed patients reported work productivity impairment. On average, employed UC patients reported 30-40% WPAI on a weekly basis, resulting in a mean indirect cost of 1.12 million Japanese yen (€8,799) per patient annually. Males, moderate-to-severe disease activity, and low treatment adherence (<80%) were associated with increased WPAI (p<0.05). In comparison to 5-ASA users, Bio/JAKi users had the highest work impairment, while steroid and IM users had higher activity impairment (p<0.05). Conclusion The overall HRQoL scores were lower than the average Japanese healthy population and the indirect cost due to work productivity impairment was high, equating to approximately 1/5 of the average household income. Those with lower treatment adherence consistently reported the highest work and activity impairment. The findings implicate a high disease burden and unmet needs affecting Japanese UC patients despite currently available treatments, suggesting the importance of a new convenient treatment for optimising UC outcomes. Additionally, workplace accommodations and understanding of employers on UC could assist in improving work productivity of UC patients.