Life Outcomes In Patients Research Articles

P40 Suboptimal clinical and quality of life outcomes in psoriasis patients: an evaluation of treatment patterns among the conventional systemic cohort of the British Association of Dermatologists Biologic and Immunomodulators Register

Abstract Moderate-to-severe psoriasis can be managed with conventional systemic (CS), targeted synthetic and biologic therapies. A stepwise treatment ladder paradigm is the standard of care, with CS typically prescribed first. CS exposure may be prolonged without formal guidance on treatment failure within a defined follow-up period, contrasting with specific guidance for biologics. A 2018–2019 global survey found non-switchers primarily on oral CS persisted >9 months despite greater disease severity and lower quality of life (QoL) post-initiation (Thai S, Barlow S, Lucas J, et al. Suboptimal clinical and quality of life outcomes in patients with psoriasis undertreated with oral therapies. Dermatol Ther 2023;13:1289–303); suboptimal treatment of psoriasis patients is not greatly understood. Using the UK and Ireland’s BADBIR CS cohort 2008–2022 (Amgen-sponsored), we retrospectively assessed treatment patterns and effects (PASI, PGA and DLQI) over time in routine clinical practice. Persistence was evaluated overall and at 6- and 12-month intervals. Effects were assessed at baseline, 6- and 12-months post-initiation among patients with non-missing data. 5662 patients enrolled in the BADBIR CS cohort. Most patients commenced methotrexate (n = 2822, 49.8%), ciclosporin (n = 1517, 26.8%) and acitretin (n = 1244, 22.0). Among completed therapy cycles, the mean overall length of persistence regardless of treatment was 15.9 (SD = 18.7) months. Proportions of patients that persisted at each of these intervals post-initiation were: 99.7% (n = 5646) at 6 months, 83.7% (n = 4739) at 12 months, 72.2% (n = 4088) at 24 months, 54.7% (n = 3096) at 36 months, 42.2% (n = 2387) at 48 months, 33.6% (n = 1900) at 60 months, and 27.6% (n = 1560) >60 months. At baseline (n = 4725), 85.0% of patients had severe disease (PASI > 10) and 10.6% had moderate (PASI 5–10). At 6 months (n = 3465), 25.8 and 25.6% had severe and moderate disease, respectively. At 12 months (n = 2926), 21.1 and 27.3% had severe and moderate disease, respectively. At baseline (n = 4228), 88.7% of patients reported very-to-extreme impact on QoL (DLQI ≥ 11) and 6.3% reported moderate impact (DLQI 6–10). At 6 months (n = 2959), 33.0 and 19.6% reported very-to-extreme and moderate impact on QoL, respectively. At 12 months (n = 2613), 28.6 and 19.6% reported very-to-extreme and moderate impact on QoL, respectively. Findings suggest that despite suboptimal clinical and QoL outcomes after 6 months, most patients persisted on CS beyond 12 months, with a quarter persisting >5 years. Long-term exposure to some CS may also increase the risk of toxicity. Defining treatment failure within a specific follow-up period for CS may result in earlier switches to targeted systemic therapies. Stringent guidance earlier in the treatment paradigm would greatly benefit patients with moderate-to-severe psoriasis and their treatment journey.

Penile length after penile implant surgery is determined by stretched penile length before surgery.

While various treatment modalities exist, penile prosthesis (PP) implantation offers a permanent solution for patients that do not respond to or are not suitable for other treatment options for erectile dysfunction. The aim of this study was to establish stretched penile length before surgery as a reliable determining factor of penile length after penile implant surgery. For this study, data on penile length before and after PP surgery from three European centers was analyzed. Penile length measurements were conducted preoperatively and postoperatively in different conditions using standardized techniques. Only virgin cases were included and a complete case analysis was performed. The outcome of this study was the comparison of stretched penile length before and the inflated penile length after PP surgery. Data on penile length before and after PP of 361 patients was analyzed. Preoperative stretched penile length was equal to postoperative inflated penile length in 33% of patients. The absolute mean difference between pre-surgery stretched and postoperative inflated lengths was 1.1cm. No correlation was found between implanted cylinder length and postoperative penile length. Additionally, the choice of implant type did not significantly affect postoperative penile length outcomes. Our findings confirm the reliability of preoperative stretched penile length as a tool for proper patient counseling before PP surgery. Although our study is overpowered, our results show that preoperative stretched penile length serves as a reliable predictor of postoperative penile length outcomes after PP surgery. By providing clinicians with a tool for patient counseling, our findings contribute to enhancing satisfaction and quality of life outcomes in patients undergoing PP implantation. Preoperative stretched penile length serves as a reliable predictor of postoperative penile length outcomes after PP surgery.

Outcome of a Physical Rehabilitation Program on Functionality and Impact on Quality of Life in Postoperative Liver Transplant Patients: A Systematic Review

Objectives: To conduct a systematic review of the literature on the outcomes of a physical rehabilitation program on functionality and identify possible impacts on quality of life in patients after liver transplantation. Methods: Controlled clinical trials and observational studies were selected from the PubMed, SciELO, and BIREME databases that "t the PICO (P – population; I – intervention; C – comparison; O – outcomes) question “what are the bene"ts of a physical rehabilitation program on functionality and quality of life outcomes in patients undergoing liver transplantation?” Studies written in English, Portuguese, and Spanish, published in the last 10 years were selected. After selection, the Physiotherapy Evidence Database (PEDro) scale was used to perform the methodological evaluation of the studies. Results and Discussion: A total of "ve interventionist articles were selected, most of which had good methodological quality. Only one study did not associate resistance training with aerobic exercises, but all had signi"cant results regarding increased functional capacity and reduced perception of fatigue after liver transplantation. Conclusion: !e studies indicated that the association of a resistance training program associated with aerobic training is bene"cial in terms of muscle strength gain, exercise capacity, and perception of fatigue.

A Scoping Review of Patient Health-Related Quality of Life Following Surgery or Molecular Testing for Individuals with Indeterminate Thyroid Nodules.

Molecular testing can reduce the need for diagnostic thyroidectomy in cytologically indeterminate thyroid nodules. However, the health-related quality of life in patients managed with molecular testing is not well studied. The objective of this scoping review was to identify and analyze the health-related quality of life outcomes in patients with indeterminate thyroid nodules who are expected to undergo or have undergone surgery or molecular testing. A comprehensive search was conducted on PubMed, Scopus, PsychINFO, and Embase to identify relevant studies. The search terms included "thyroid neoplasms" or "thyroid nodule" and "molecular testing" or "surgery" and "quality of life". The included articles were analyzed for their main study objective, study design, participant characteristics, and main results. Eight studies were included in this scoping review. Four evaluated the quality-adjusted life years for patients with indeterminate thyroid nodules. Three of these studies found that molecular testing slightly improved quality-adjusted life years compared to surgery, while one study found no difference. Two studies assessed surgical health-related quality of life outcomes and reported that patients with indeterminate thyroid nodules who were expected to undergo surgery favored surgical procedures, while those who underwent surgery experienced impaired health-related quality of life. Two studies evaluated molecular testing in patients with indeterminate thyroid nodules and found that the final molecular test result significantly impacted health-related quality of life outcomes. Patients with suspicious/positive molecular test results had worse symptoms of goiter, anxiety, and depression, while those with benign results had preserved health-related quality of life scores. Patients with benign results from molecular testing experience better health-related quality of life within the first year compared to those with benign surgical outcomes. This scoping review highlights the importance of considering health-related quality of life outcomes in the management of patients with indeterminate thyroid nodules. Benign molecular testing results yield better quality of life than benign surgical outcomes within the first year, suggesting molecular testing as a preferable option. Further research comparing the impact of surgery and molecular testing on health-related quality of life is needed to improve shared decision-making and patient outcomes.

ID: 343570 Long-Term Quality of Life Outcomes in Patients with Deep Brain Stimulation for Dystonia

ID: 343570 Long-Term Quality of Life Outcomes in Patients with Deep Brain Stimulation for Dystonia

A systematic review of health-related quality of life outcomes in patients with advanced breast cancer treated with palbociclib.

Aim: To evaluate the impact of palbociclib treatment on health-related quality of life (HRQoL) in patients with hormone receptor-positive, human epidermal growth factor 2-negative advanced breast cancer (HR+/HER2- aBC) or metastatic breast cancer (mBC) in both the clinical and real-world setting. Materials & methods: A systematic literature review was conducted to identify clinical trials and real-world evidence studies up to June 2023 that reported HRQoL outcomes in patients with HR+/HER2- aBC or mBC treated with Palbociclib. Results: 15 unique studies reported across 35 records were identified. Of these, seven were randomized controlled trials (RCTs), three were single-arm clinical trials and five were real-world evidence (RWE) studies. HRQoL was generally found to be maintained in patients with HR+/HER2- aBC or mBC across RCTs, single-arm clinical trials and RWE studies. HRQoL measures across instruments, study types and line of therapy, were largely reported to be at least maintained if not improved from baseline among patients treated with palbociclib and were observed to be comparable or better in the palbociclib group versus monotherapy control arm in RCTs. Similar results were seen for treatment-related outcomes (e.g., sexual functioning, upset by hair loss, systemic therapy side effects etc.), and important individual patient outcomes, including pain, fatigue and physical functioning. Findings were also consistent across key clinical characteristics (visceral metastases, neutropenia), as well as patient populations often underrepresented in clinical trials (Asian patients, older adults). Conclusion: Overall, current evidence suggests that HRQoL is largely preserved with the addition of palbociclib to endocrine therapy in patients with HR+/HER2- aBC or mBC across study types and populations.

Assessment of the perceptions of health-related quality of life in Greek patients undergoing automated peritoneal dialysis with remote monitoring: A qualitative study.

This study aimed to explore in depth the lived experience and quality of life outcomes in patients receiving automated peritoneal dialysis (APD) treatment. The study adhered to the standards of the Consolidated Criteria for Reporting Qualitative Research. A total of 19 APD patients were recruited and assessed using in-depth semi-structured interviews on various aspects of life with respect to APD modality. The interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis. Study findings generated five superordinate themes: (a) treatment-free daily routine, (b) sleep disturbances, (c) remote care, (d) limitations of peritoneal dialysis, and (e) the dimension of chronic disease. Further analysis of the material revealed the relationship of these themes with individual patient characteristics. Overall, our findings suggest that APD characteristics contribute to the perceptions of quality of life in patients under dialysis considerably.

The Role of L1PA in Patient-reported Outcomes in Patients Undergoing Single-level Lumbar Fusion for Degenerative Spondylolisthesis.

Retrospective cohort study. To determine whether the L1 pelvic angle (L1PA) can be used to predict quality of life outcomes for adults one year after L4-L5 fusion to treat degenerative spondylolisthesis. L1PA is beneficial in the evaluation of preoperative and postoperative quality of life outcomes in patients undergoing surgery for spinal deformity. No studies have examined its utility in surgical patients with degenerative spinal disease. Patients undergoing L4-L5 posterolateral decompression and fusion or transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis were grouped by preoperative and postoperative L1PA, and further stratified by cut offs of >7.2° and <7.2° based on previous literature. We also stratified patients by presence of an ideal calculated L1PA, defined as (0.5×Pelvic incidence) -21 +/-5°, as proposed by prior literature. Preoperative, one-year postoperative and Δ (postoperative minus preoperative) patient-reported outcome measures (PROMs) and radiographic measurements were collected. Twenty-four patients were identified with preoperative L1PAs <7.2° and 132 with L1PAs >7.2°. Eighteen patients were identified with postoperative L1PAs <7.2° and 138 with L1PAs>7.2°. Sixty-five and fifty-seven patients were identified as having ideal calculated preoperative and postoperative L1PAs, respectively. When using absolute cutoffs, L1PA correlated with pelvic tilt, pelvic incidence, and pelvic incidence-lumbar lordosis mismatch (PI-LL). When using calculated L1PAs, L1PA correlated with lumbar lordosis, PI-LL, pelvic tilt and sacral slope. With respect to PROMs, no statistically significant differences existed between cohorts both preoperatively and at one-year postoperatively on either univariate and multivariate analyses. L1PA may be a helpful radiographic consideration that translates to clinically relevant outcomes in spinal deformity. However, it does not appear as predictive of patient outcomes after single-level fusion for patients with L4-L5 degenerative spondylolisthesis. Further studies are warranted to investigate the role of L1PA in degenerative spine patients.

Quality of life outcomes in patients with resectable dedifferentiated liposarcoma treated with neoadjuvant immunotherapy.

e23552 Background: Currently there is a lack of robust data on health-related quality of life outcomes for patients with retroperitoneal sarcoma. The purpose of this study was to look at trends in health-related quality of life outcomes for patients and determine what symptoms impacted patients the most. Patients with surgically resectable dedifferentiated liposarcoma who were participating in a randomized, phase II, non-comparative trial of combination nivolumab (nivo) and ipilimumab (ipi/nivo) were selected to participate in this study. Methods: Five patients were randomized to participate in structured qualitative interviews. Three patients were randomized to the nivo/ipi arm and 2 to the nivo arm. The interviews were conducted at 6 separate time points, both during receipt of neoadjuvant therapy and after tumor resection. Questions were structured around ten themes which included treatment side effects, abdominal complications, appetite, energy levels, quality of life effects, and financial complications. Patient responses were transcribed, coded, and themes in symptoms during treatment were identified. Results: Different themes in symptoms emerged during each time-period of treatment. During the pretreatment period patients were more likely to report abdominal complaints that they attributed to their primary tumor. During neoadjuvant immunotherapy (week 3) patients reported more skin complaints, including the development of rashes and pruritis. These tended to improve by their preoperative visit. Patients reported typical postoperative symptoms at their 6-week post operative visit including increases in pain medications, muscle pain, and some abdominal soreness. By one year patients reported no significant symptoms and demonstrated resolution of all prior symptoms. Overall patients reported few energy and sleep related symptoms throughout their treatment course. Conclusions: For patients with resectable dedifferentiated liposarcoma receiving immune checkpoint blockade, health-related quality of life symptoms were present throughout their treatment course. Common themes that emerged demonstrated a lack of severe symptoms experienced by patients in either arm and resolution of symptoms by one year post treatment. Our interview results can help clinicians focus on symptoms that are impactful to patients in future clinical trials.

The quality of life outcome in patients with head and neck squamous cell cancer treated using chemoradiotherapy

ObjectiveOrgan preservation is a goal of head and neck squamous cell cancer (HNSCC) treatment. chemoradiotherapy remains one of the main treatment options and is widely recognized as a method with organ-preserving potential and outcomes comparable to those of surgery. However, few studies have investigated the quality of life (QOL) of patients with HNSCC treated using chemoradiotherapy, therefore, we aimed to retrospectively evaluate how QOL changes pre and post-chemoradiotherapy. MethodsWe evaluated QOL outcomes in patients who underwent initial radical chemoradiotherapy for HNSCC at the Department of Otolaryngology and Head and Neck Surgery Kitasato University Hospital from 2018 to 2021. We used the Cancer Fatigue Scale (CFS) and the combined European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35 questionnaires at pre-treatment, three months and six months post-treatment. ResultsWe obtained 37 and 29 responses from the CFS and EORTC QLQ-C30/H&N35 questionnaire, respectively. From the CFS, the physical fatigue score at three months post-treatment deteriorated more than that at pre-treatment, and significantly improved by six months post-treatment. The total score worsened significantly at three months and there was a trend toward improvement at six months. In the EORTC QLQ-C30, physical and social functioning declined in three months and did not improve within six months. Fatigue was substantially worse at three months and significantly improved at six months but did not reach the same level as that before treatment. Appetite loss was also significantly worse at three months. In the QLQ-H&N35 questionnaire, sensory issues, trouble with social contact, and dry mouth were significantly worse at three months and did not improve within six months. Sticky saliva also worsened at three months and significantly improved at six months. ConclusionThere were some problems associated with chemoradiotherapy. Some patients showed an improvement, while others continued to have challenges. In Japan, chemoradiotherapy was shown to have a long-term impact on the patient's life.

Quality of life outcomes in patients receiving dental implants in vascularised bone flaps for mandibular reconstruction

Resection, reconstruction, and rehabilitation of the mandible impact function and health related quality of life (HRQOL). In this study, we aimed to understand the impact of delayed versus immediate dental implant placement. A cross-sectional and prospective study was conducted including patients who underwent reconstruction of the mandible via osseous vascularised bone flaps and dental implants. The FACE-Q Head and Neck Cancer module and the MD Anderson Dysphagia Inventory and Speech Handicap Index were used to evaluate HRQOL. A total of 187 implants were placed in 52 patients, of which 44 patients (85%) completed questionnaires. Immediate dental implant placement was associated with superior FACE-Q appearance (p = 0.02), oral competence (p = 0.004), smile distress (p = 0.03), and satisfaction with information (p = 0.004). Dentoalveolar rehabilitation through the placement of immediate dental implants at the time of surgery was found to be associated with higher HRQOL scores related to appearance, eating and drinking, oral competence, and smile.

Placebo response in patients with Dravet syndrome: Post-hoc analysis of two clinical trials

ObjectiveDravet syndrome is a rare, early childhood-onset epileptic and developmental encephalopathy. Responses to placebo in clinical trials for epilepsy therapies range widely, but factors influencing placebo response remain poorly understood. This study explored placebo response and its effects on safety, efficacy, and quality of life outcomes in patients with Dravet syndrome. MethodsWe performed exploratory post-hoc analyses of pooled data from placebo-treated patients from the GWPCARE 1B and GWPCARE 2 randomized controlled phase III trials, comparing cannabidiol and matched placebo in 2–18 year old Dravet syndrome patients. All patients had ≥4 convulsive seizures during a baseline period of 4 weeks. Results124 Dravet syndrome-treated patients were included in the analysis (2–5 years: n = 35; 6–12 years: n = 52; 13–18 years: n = 37). Convulsive seizures were experienced by all placebo group patients at all timepoints, with decreased median convulsive seizure frequency during the treatment period versus baseline; the number of convulsive seizure-free days was similar to baseline. Convulsive seizure frequency had a nominally significant positive correlation with age and a nominally significant negative correlation with body mass index. Most placebo-treated patients experienced a treatment-emergent adverse event; however, most resolved quickly, and serious adverse events were infrequent. Placebo treatment had very little effect on reported Caregiver Global Impression of Change outcomes versus baseline. InterpretationPlacebo had little impact on convulsive seizure-free days and Caregiver Global Impression of Change versus baseline, suggesting that these metrics may help differentiate placebo and active treatment effects in future studies. However, future research should further assess placebo responses to confirm these results.

Quality of life outcomes in patients of genitourinary tuberculosis undergoing major surgical procedures: A single center experience

Objectives In India, an estimated 18% of patients suffering from tuberculosis (TB), have Genitourinary tuberculosis (GUTB). Understanding the effect of GUTB on overall health and QoL is essential for providing better patient care and modifying health programs. The present study was designed to provide insight into the change in QoL in GUTB patients following surgical management using the World Health Organisation Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Material and Methods A total of 35 patients, who underwent extirpative or reconstructive surgery at our center from January 2016 to December 2021 were included. Demographic profiles, clinical details, laboratory data, radiological imaging findings, and microbiological data were recorded from our database. To assess the impact of the disease and the subsequent surgical treatment, patients themselves completed the WHOQOL-BREF Hindi questionnaires twice, based on the recall method. Results The mean age of the study cohort was 36.89±12.64 years. Lower urinary tract symptoms (LUTS) were the most common (68.6%) presenting symptoms. Kidney alone or in combination with other organs was involved in all but six cases, amongst them three cases each exclusively involved the ureter and bladder only. Isolated kidney was involved in 7/35 (20%) patients. Preoperative diversion of the upper tract was needed in 27 patients. Nephrectomy was the most commonly performed surgery (48.6%) overall. Ileal conduit with cystectomy was the most frequently performed reconstructive surgery (14.3%). Amongst all the domains, preoperative mean physical and environmental domain scores improved from 51.08 ± 12.39 to 57.71 ± 14.53 and 55.37 ± 13.41 to 64.02 ± 16.59 after surgery, respectively. Conclusion GUTB significantly affects all domains, psychological and physical being the worst affected facets. With surgical treatment, improvement in overall QoL and its domains could be achieved.

Surgical Intervention is Associated with Improvement in Health-Related Quality of Life Outcomes in Patients with Symptomatic Sacral Tarlov Cysts: Results from a Prospective Longitudinal Cohort Study

The treatment of symptomatic Tarlov cysts remains a controversial topic within neurosurgery. We describe our experience with patients who underwent surgical intervention for sacral Tarlov cysts at a single institution. General and disease-specific outcome measures were used to assess health-related quality of life. Patients who underwent surgical treatment for one or more sacral Tarlov cysts between 2018 and 2021 were included. The Tarlov Cyst Quality of Life (TCQoL), a validated disease-specific measure, was the primary outcome of the study. Secondary outcomes included general outcome measures: 36-Item Short Form Survey, the Oswestry Disability Index, and Visual Analog Scale. Patients were followed at 3, 6, and 12 months postoperative. Repeated measures analyses were used to assess change from preoperative to 12 months postoperative. Data were obtained from 144 patients who underwent surgery for sacral Tarlov cysts, average age 52.3 ± 11.3 years, 90.3% female. Patients reported significant mean improvement on the TCQoL over time (preoperative 3.2±0.1; 3-months postoperative 2.1±0.1; 6-months 1.9±0.1; 12-months 1.9±0.1; P< 0.001). Patient age and duration of symptoms were not associated with outcome. 82.3% of patients reported improvement on TCQoL. There was not a significant difference in the proportion of patients reporting improvement on TCQoL by cyst size (small 90.9% vs. large 77.9%; P = 0.066). Our longitudinal series demonstrated patient-reported improvement following surgery for symptomatic sacral Tarlov cysts using a validated disease-specific health-related quality of life scale through 12 months following surgery. Patient age and preoperative duration of symptoms were not correlated with outcome.

Health-related quality of life outcomes in patients with psoriatic arthritis and skin disease: A systematic review

Health-related quality of life outcomes in patients with psoriatic arthritis and skin disease: A systematic review

Complexity of surgery and treatment burden in patients with peritoneal malignancy is not determined by addition of hyperthermic intraperitoneal chemotherapy.

This study describes surgical and quality of life outcomes in patients with peritoneal malignancy treated by cytoreductive surgery (CRS) alone compared with a subgroup treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). Peritoneal malignancy patients undergoing surgery between 2017 and 2023 were included. The cohort was divided into patients treated by CRS and HIPEC and those treated by CRS without HIPEC (including CRS only or maximal tumour debulking (MTB)). Main outcomes included surgical outcomes, survival, and quality of life. Groups were compared using non-parametric tests and log-rank test was used to compare survival curves. 403 had CRS and HIPEC, 25 CRS only and 15 MTB. CRS and HIPEC patients had a lower peritoneal carcinomatosis index (12.0 vs. 17.0 vs. 35.0; P < 0.001) and longer surgical operative time (9.3 vs. 8.3 vs. 5.2 h; P < 0.001), when compared to CRS only and MTB, respectively. No other significant difference between groups was observed. The optimal management of selected patients with resectable peritoneal malignancy incorporates a combined strategy of CRS and HIPEC. When HIPEC is not utilized, due to significant residual disease or comorbidity precluding safe delivery, CRS alone is associated with good outcomes. Hospital stay and complications are acceptable but not significantly different to the CRS and HIPEC group. CRS alone is a complex intervention requiring comparable resources with good outcomes. In view of our findings 'intention to treat' with CRS and HIPEC should be the basis for resource allocation and funding.

Long-term quality of life outcomes in patients undergoing microsurgical resection of vestibular schwannoma

BackgroundWhile previous studies have assessed patient reported quality of life (QOL) of various vestibular schwannoma (VS) treatment modalities, few studies have assessed QOL as related to the amount of residual tumor and need for retreatment in a large series of patients. Objective: To assess patient reported QOL outcomes following VS resection with a focus on extent of resection and retreatment. MethodsA retrospective chart review was performed using single-center institutional data of adult patients who underwent VS resection by the senior authors between 1989-2018 at Loyola University Medical Center. The Penn Acoustic Neuroma Quality of Life (PANQOL) survey was sent to all patients via postal mail. ResultsFifty-five percent of 367 total patients were female with a mean age of 61.6 years (SD 12.63). The mean period between surgery and PANQOL response was 11.4 years (IQR: 4.74-7.37). The median tumor size was 2 cm (IQR: 1.5-2.8). The mean total PANQOL score was 70 (SD 19). Patients who required retreatment reported lower overall scores (μdiff = -10.11, 95% CI: -19.48 to -0.74; p = 0.03) and face domain scores (μdiff = -20.34, 95% CI: -29.78 to -10.91; p < .001). There was no association between extent of resection and PANQOL scores in any domain. ConclusionIn an analysis of 367 patients who underwent microsurgical resection of VS, extent of resection did not affect PANQOL scores in contrast to previous reports in the literature, while the need for retreatment and facial function had a significant impact on patient-reported outcomes.

Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy.

This study aims to investigate the effects of external dacryocystorhinostomy (DCR) surgery on tear meniscus parameters and assess its relationship with improvements in quality of life (QoL) in patients with nasolacrimal duct obstruction (NLDO). This prospective study included 30 patients diagnosed with NLDO who underwent external DCR surgery. Tear meniscus (TM) parameters, including height, depth and area, were measured using anterior segment optical coherence tomography. Lacrimal symptom questionnaire (LacQ), Munk scores and Glasgow benefit inventories (GBI) were collected. Statistical analysis was performed to evaluate the correlation between tear meniscus changes and improvements in QoL. TM height, depth and area decreased from preoperative median measurements (0.09mm2, 0.37mm, 0.56mm) to postoperative median measurements (0.03mm2, 0.21mm, 0.30mm) (p < 0.001). Lacrimal symptom scores and Munk scores showed a significant improvement at 3-month postoperatively (p < 0.001). The GBI scores also demonstrated a significant improvement, indicating a positive impact on the patients' QoL. (p < 0.001). A statistically significant correlation was found between the change in TM parameters and LacQ lacrimal symptom scores. External DCR surgery leads to significant improvements in tear meniscus parameters and quality of life outcomes in patients with NLDO. The decreased in TM height and TM area indicates improved tear film dynamics and decreased tear volume, which positively impact the patients' ocular comfort and overall well-being. This study highlights the importance of tear meniscus evaluation as a potential market for assessing the success of DCR surgery and its impact on patients' QoL.

P862 Effects of induction and maintenance therapy with risankizumab on health-related quality of life outcomes in patients with moderately to severely active ulcerative colitis: A post-hoc analysis of Phase 2b/3 trials

Abstract Background Ulcerative colitis (UC) has a detrimental impact on patients’ health-related quality of life (HRQoL).1 Long-term treatment goals for patients with moderately to severely active UC include restoration of HRQoL. This post-hoc analysis evaluated the effect of induction and maintenance treatment with risankizumab (RZB) on HRQoL outcomes. Methods Data from two Phase 2b/3 clinical trials (INSPIRE induction: NCT03398148 and COMMAND maintenance: NCT03398135) were evaluated. Patients received RZB 1200 mg intravenous (IV) or placebo (PBO) induction treatment at weeks 0, 4, and 8. Patients with a clinical response per Adapted Mayo score to RZB IV were randomised 1:1:1 to subcutaneous (SC) RZB 180 or 360 mg, or placebo (PBO [RZB withdrawal] SC) every 8 weeks for 52 weeks of maintenance. The proportion of patients achieving a meaningful within-person change (MWPC) for each HRQoL outcome was reported. HRQoL outcomes included Functional Assessment of Chronic Illness Therapy-Fatigue, disease-specific instruments such as Inflammatory Bowel Disease Questionnaire (IBDQ) and Ulcerative Colitis Symptom Questionnaire (UCSQ), as well as generic quality-of-life questionnaires like Work Productivity and Activity Index-Ulcerative Colitis (WPAI-UC), 36-Item Short-Form Survey (SF-36), and EuroQoL 5 Dimensions 5 Levels. MWPCs were measured from baseline to induction Week 12 and to maintenance Week 52. Estimated differences in proportions with 95% confidence intervals and p-values between RZB and PBO were compared using the Cochran-Mantel-Haenszel test adjusting for baseline strata. Results For RZB 1200 mg IV (n=650) versus PBO IV-treated (n=325) patients, a greater proportion of patients achieved MWPC across all HRQoL outcomes at Week 12 of induction (p&amp;lt;0.01; Table). At Week 52 of maintenance, a greater proportion of patients treated with RZB 180 mg SC (N=179) versus PBO (withdrawal) SC (N=183) achieved MWPC across all HRQoL outcomes (p&amp;lt;0.05), except for absenteeism from WPAI-UC (p=0.33). For RZB 360 mg SC (N=186) versus PBO (withdrawal) SC, a greater proportion of patients achieved MWPC for UCSQ, IBDQ, and SF-36 physical component summary (all p&amp;lt;0.05). Conclusion In this analysis, a greater proportion of patients treated with RZB versus PBO achieved MWPC on various HRQoL outcomes after completing 12-week induction IV therapy. HRQoL improvements were sustained up to Week 52 of treatment. This suggests RZB has the potential to help patients achieve restoration of HRQoL as a long-term goal of treatment in patients with moderately to severely active UC. 1. Mavroudis G. Therap Adv Gastroenterol. 2022;15:17562848211062406.

The Efficacy of Internet-Based Cognitive Behavioral Therapy for Patients With Breast Cancer: A Systematic Review and Meta-Analysis.

To systematically review and analyze the effects of Internet-based cognitive behavioral therapy (ICBT) on physical, psychological, and daily life outcomes in patients with breast cancer. Relevant studies were retrieved from Wanfang, CBM, CNKI, CINAHL, PsycINFO, Web of Science, The Cochrane Central Register of Controlled Trials, Embase and PubMed from inception to December 2023. Two independent authors conducted the literature search and data extraction. The Cochrane bias risk assessment tool was used to evaluate the included studies for methodological quality, and the data analysis was performed using Stata (Version 15.0). Among 700 records, 11 randomized controlled trials were identified in this study. The meta-analysis showed statistically significant effects of ICBT on depression (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI): -0.70 to -0.06, P = .019) and insomnia severity (SMD = -0.71, 95% CI: -1.24 to -0.19, P = .008). However, there were no statistically significant effects on anxiety, fatigue, sleep quality and quality of life. ICBT appears to be effective for improving depression and reducing insomnia severity in patients with breast cancer, but the effects on anxiety, fatigue, sleep quality and quality of life are non-significant. This low-cost treatment needs to be further investigated. More randomized controlled trials with a larger sample size, strict study design and multiple follow-ups are required to determine the effects of ICBT on patients with breast cancer.