Tu1256 Comparison of Ulcerative Colitis With Crohn's Disease From the Perspective of Patient Burden

Abstract

Background: Published studies evaluating the impact of inflammatory bowel disease (IBD) on disability have suggested that patients (pts) with Crohn's disease (CD) are more affected by their disease than pts with ulcerative colitis (UC).1 However; this outcome may depend on the severity of the disease. We assessed whether this is true in a real-world setting for pts rated moderate/severe in terms of health status and ability to work. Methods: Data from the Adelphi Disease Specific Programme (DSP®), a large, multinational, cross-sectional survey conducted from July to September 2012, were used in this analysis. Pts were recruited from France, Germany, Italy, Spain, and the United States. Pts with moderate/severe UC and CD were selected using the physician's assessment of disease severity at the time of the survey. Pts recorded their health state using the EQ-5D: (domains are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and rated their overall health on a visual analog scale (VAS) of 0 to 100, (0 was the ‘worst' and 100 the ‘best imaginable health state'). Pts completed the Work Productivity and Activity Impairment Questionnaire (WPAI) questionnaire, reporting on work timed missed, impairment while working, overall work impairment, and non-work activity impairment. Comparisons between groups were assessed using Fisher's exact tests for categorical variables and Mann-Whitney tests for continuous variables. Results: 2065 pts (981 with UC vs 1084 with CD) made up the study population (mean age 39.4 years vs 39.6 years, P=0.79; women: 50.8% vs 50.5%, P=0.89, respectively). The percentages of pts with UC vs CD were comparable across countries. The proportion of pts with moderate/severe UC vs CD was comparable (87.4%/12.6% vs 85.4%/14.6%, P= 0.20, respectively. Outcomes for pts with UC vs CD were largely comparable (Table). Overall EQ-5D VAS scores were similar (62.3 vs 61.7) indicating pts are equally bothered by the two conditions. In terms of individual EQ-5D domains, 71.3% vs 74.6% of UC vs CD pts had moderate/extreme pain or discomfort, 52.2% vs 50.7% were moderately/extremely anxious or depressed, and 42.8% vs 41.4% had problems performing their usual activities because of their disease. Regarding productivity, pts (UC vs CD) had an overall impairment while working of 35.1% vs 34.8% (taking into account time off and reduced productivity while at work) and similarly a reduction of 40.0% vs 38.9% in their ability to perform nonwork related activities.Conclusions:Results of this study in a real-world setting demonstrated that moderate/severe UC and CD equally affected pts' general quality of life and their ability to work. This suggests that UC is equally as burdensome as CD and that this should be considered when making treatment decisions for UC.