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Persistent disease burden despite advanced therapies in inflammatory bowel disease: a real-world patient-reported
Charalampos Tzanetakos1, Vasiliki-Rafaela Vakouftsi2, George Mavridoglou3
1Health Through Evidence, Athens, Greece.
Insights
Inflammatory bowel disease (IBD) patients in Greece on advanced therapies face significant burdens, including active disease and impaired quality of life. Many report dissatisfaction with treatments, indicating unmet needs for better management strategies.
Area of Science:
- Gastroenterology
- Clinical Research
- Patient Outcomes
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), presents a lifelong challenge despite therapeutic advancements.
- The study addresses the substantial disease burden and unmet needs experienced by IBD patients undergoing advanced therapies.
Purpose of the Study:
- To investigate the disease burden and unmet needs in Greek IBD patients receiving advanced therapies.
- To identify factors associated with patient-reported outcomes in this population.
Main Methods:
- A structured, self-reported questionnaire was administered to 287 adult IBD patients (201 CD, 86 UC) in Greece.
- Data collected included sociodemographics, disease activity, comorbidities, and patient-reported outcomes (PROs) such as quality of life, work productivity, and depressive symptoms.
- Statistical analyses, including logistic regression, were employed to determine associated factors.
Main Results:
- Over half of patients (57.1%) had active disease, and a large majority (76.4%) reported impaired quality of life.
- Significant work productivity loss (30.3%), activity impairment (38.4%), and moderate-to-severe depressive symptoms (nearly 50%) were observed.
- Treatment dissatisfaction (39.1%) and reduced adherence (10.9%) were notable, with higher disease activity correlating with worse outcomes.
Conclusions:
- Advanced therapies do not fully mitigate the substantial burden of IBD in Greek patients.
- A significant unmet need exists, characterized by poor quality of life, work impairment, depressive symptoms, and treatment dissatisfaction.
- More effective management strategies are required to address the persistent challenges faced by IBD patients.
Objectives:
Despite therapeutic advances, inflammatory bowel disease (IBD) remains a lifelong debilitating disorder with substantial burden. The study aimed to investigate disease burden and unmet needs in IBD patients receiving advanced therapies in Greece.
Methods:
Between October 2023 and January 2024, adult CD and UC patients who were members of Hellenic Society of Crohn's disease's and Ulcerative Colitis' patients (HELLESCC) and receiving advanced therapies completed a structured self-reported questionnaire. The survey collected data on sociodemographic characteristics, smoking status, comorbidities, disease activity, disease characteristics, current medications, and patient-reported outcomes (PROs; Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment [WPAI], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction and adherence). Both univariate and multivariate logistic regression analyses were performed to determine associated factors.
Results:
Among 287 patients with IBD (201 with CD, 86 with UC) receiving advanced therapies, 57.1% had active disease. Overall, 76.4% reported impaired QoL, 30.3% work productivity loss, and 38.4% activity impairment, while nearly half exhibited moderate-to-severe depressive symptoms. Notably, 39.1% expressed dissatisfaction with their advanced therapy, while 10.9% reported reduced adherence. No significant differences were observed between CD and UC patients across PROs, except for adherence. Higher disease activity was consistently associated with worse QoL, greater work impairment, increased depressive symptoms, and lower treatment satisfaction.
Conclusion:
Despite advanced therapies, IBD burden remains substantial among Greek patients. A considerable proportion experience poor QoL, increased work impairment, significant depressive symptoms, and persistent disease activity. Marked treatment dissatisfaction, reported by four out of ten patients, highlights an unmet need for more effective management strategies.
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