TY - JOUR
T1 - Comparison of health-related quality of life and disability in ulcerative colitis patients following restorative proctocolectomy with ileal pouch-anal anastomosis versus anti-tumor necrosis factor therapy
AU - van Gennep, Sara
AU - Sahami, Saloomeh
AU - Buskens, Christianne J.
AU - van den Brink, Gijs R.
AU - Ponsioen, Cyriel Y.
AU - D'Hoore, André
AU - de Buck van Overstraeten, Anthony
AU - van Assche, Gert
AU - Ferrante, Marc
AU - Vermeire, Séverine
AU - Bemelman, Willem A.
AU - D'Haens, Geert R. A. M.
AU - Löwenberg, Mark
PY - 2017
Y1 - 2017
N2 - Health-related quality of life (HRQL) and disability were compared in ulcerative colitis (UC) patients who underwent restorative proctocolectomy versus patients who received treatment with anti-tumor necrosis factor (anti-TNF) agents. UC patients who underwent restorative proctocolectomy or started anti-TNF treatment between January 2010 and January 2015 were included at two tertiary referral centers. A matched cohort was created using propensity score matching for the covariates disease duration, Montreal classification, age, and sex. HRQL and disability were assessed using the Colorectal Functional Outcome (COREFO), Inflammatory Bowel Disease Disability Index (IBD-DI), EuroQol-5D-3L, and Short Form 36 (SF-36) questionnaires. In total, 297 patients were included, of whom 205 (69%) patients responded. Fifty-nine pouch patients were matched to 59 anti-TNF-treated patients. Pouch patients reported better general health scores (P=0.042) compared with the anti-TNF group (SF-36). No differences were found for the EuroQol-5D-3L and IBD-DI between the two groups. Pouch patients had significantly higher COREFO scores compared with anti-TNF-treated patients for 'stool frequency' (P <0.001), 'antidiarrheal medication use' (P <0.001), and 'stool-related aspects' (P=0.004), of which the latter was because of a higher perianal skin irritation frequency (P <0.001). UC patients who underwent restorative proctocolectomy reported a higher bowel movement frequency and more perianal skin irritation compared with anti-TNF-treated patients, but this did not affect overall disease-specific disability outcomes. Patients in the surgery group reported better outcomes for generic health compared with those in the anti-TNF group
AB - Health-related quality of life (HRQL) and disability were compared in ulcerative colitis (UC) patients who underwent restorative proctocolectomy versus patients who received treatment with anti-tumor necrosis factor (anti-TNF) agents. UC patients who underwent restorative proctocolectomy or started anti-TNF treatment between January 2010 and January 2015 were included at two tertiary referral centers. A matched cohort was created using propensity score matching for the covariates disease duration, Montreal classification, age, and sex. HRQL and disability were assessed using the Colorectal Functional Outcome (COREFO), Inflammatory Bowel Disease Disability Index (IBD-DI), EuroQol-5D-3L, and Short Form 36 (SF-36) questionnaires. In total, 297 patients were included, of whom 205 (69%) patients responded. Fifty-nine pouch patients were matched to 59 anti-TNF-treated patients. Pouch patients reported better general health scores (P=0.042) compared with the anti-TNF group (SF-36). No differences were found for the EuroQol-5D-3L and IBD-DI between the two groups. Pouch patients had significantly higher COREFO scores compared with anti-TNF-treated patients for 'stool frequency' (P <0.001), 'antidiarrheal medication use' (P <0.001), and 'stool-related aspects' (P=0.004), of which the latter was because of a higher perianal skin irritation frequency (P <0.001). UC patients who underwent restorative proctocolectomy reported a higher bowel movement frequency and more perianal skin irritation compared with anti-TNF-treated patients, but this did not affect overall disease-specific disability outcomes. Patients in the surgery group reported better outcomes for generic health compared with those in the anti-TNF group
U2 - https://doi.org/10.1097/MEG.0000000000000798
DO - https://doi.org/10.1097/MEG.0000000000000798
M3 - Article
C2 - 27902515
SN - 0954-691X
VL - 29
SP - 338
EP - 344
JO - European Journal of Gastroenterology & Hepatology
JF - European Journal of Gastroenterology & Hepatology
IS - 3
ER -