TY - JOUR
T1 - Health-related quality of life in patients with primary sclerosing cholangitis
T2 - A longitudinal population-based cohort study
AU - Mol, Bregje
AU - van Munster, Kim N.
AU - Bogaards, Johannes A.
AU - Weersma, Rinse K.
AU - Inderson, Akin
AU - de Groof, E. Joline
AU - Rossen, Noortje G. M.
AU - Ponsioen, Willemijn
AU - Turkenburg, Maud
AU - van Erpecum, Karel J.
AU - Poen, Alexander C.
AU - the EpiPSC2 Study Group
AU - Spanier, B. W. Marcel
AU - Beuers, Ulrich H. W.
AU - Ponsioen, Cyriel Y.
N1 - Funding Information: The study was funded by the Dutch Organisation for Health Research and Development (ZonMw, grant number: 836041010). Publisher Copyright: © 2023 The Authors. Liver International published by John Wiley & Sons Ltd.
PY - 2023/5
Y1 - 2023/5
N2 - Background & Aims: Data regarding health-related quality of life (HRQoL) in primary sclerosing cholangitis (PSC) are sparse and have only been studied cross-sectionally in a disease which runs a fluctuating and unpredictable course. We aim to describe HRQoL longitudinally by using repeated measurements in a population-based cohort. Methods: Every 3 months from May 2017 up to August 2020, patients received digital questionnaires at home. These included the EQ-5D, 5-D Itch, patient-based SCCAI and patient-based HBI. The SF-36, measuring HRQoL over eight dimensions as well as a physical component summary (PCS) and mental component summary (MCS) score, was sent annually. Data were compared with Dutch reference data and a matched IBD disease control from the population-based POBASIC cohort. Mixed-effects modelling was performed to identify factors associated with HRQoL. Results: Three hundred twenty-eight patients completed 2576 questionnaires. A significant reduction of small clinical relevance in several mean HRQoL scores was found compared with the Dutch reference population: 46.4 versus 48.0, p =.018 for PCS and 47.5 versus 50.5, p =.004 for MCS scores. HRQoL outcomes were significantly negatively associated with coexisting active IBD (PCS −12.2, p <.001 and MCS −12.0, p <.001), which was not the case in case of quiescent IBD. Decreasing HRQoL scores were also negatively associated with increasing age (PCS −0.1 per 10 years, p =.002), female sex (PCS -2.8, p <.001), diagnosis of AIH overlap (PCS -3.7, p =.059), end-stage liver disease (PCS -3.7, p =.015) and presence of itch (PCS -9.2, p <.001 and MCS −3.1, p =.078). The odds of reporting a clinically relevant reduction in EQ-5D scores showed seasonal variation, being lowest in summer (OR = 0.48 relative to spring, p =.037). In patients with liver transplant, HRQoL outcomes were comparable to the Dutch general population. Conclusions: PSC patients report impaired HRQoL of small clinical relevance compared with the general population. After liver transplantation, HRQoL scores are at comparable levels to the general population. HRQoL scores are associated with potentially modifiable factors such as itch and IBD activity.
AB - Background & Aims: Data regarding health-related quality of life (HRQoL) in primary sclerosing cholangitis (PSC) are sparse and have only been studied cross-sectionally in a disease which runs a fluctuating and unpredictable course. We aim to describe HRQoL longitudinally by using repeated measurements in a population-based cohort. Methods: Every 3 months from May 2017 up to August 2020, patients received digital questionnaires at home. These included the EQ-5D, 5-D Itch, patient-based SCCAI and patient-based HBI. The SF-36, measuring HRQoL over eight dimensions as well as a physical component summary (PCS) and mental component summary (MCS) score, was sent annually. Data were compared with Dutch reference data and a matched IBD disease control from the population-based POBASIC cohort. Mixed-effects modelling was performed to identify factors associated with HRQoL. Results: Three hundred twenty-eight patients completed 2576 questionnaires. A significant reduction of small clinical relevance in several mean HRQoL scores was found compared with the Dutch reference population: 46.4 versus 48.0, p =.018 for PCS and 47.5 versus 50.5, p =.004 for MCS scores. HRQoL outcomes were significantly negatively associated with coexisting active IBD (PCS −12.2, p <.001 and MCS −12.0, p <.001), which was not the case in case of quiescent IBD. Decreasing HRQoL scores were also negatively associated with increasing age (PCS −0.1 per 10 years, p =.002), female sex (PCS -2.8, p <.001), diagnosis of AIH overlap (PCS -3.7, p =.059), end-stage liver disease (PCS -3.7, p =.015) and presence of itch (PCS -9.2, p <.001 and MCS −3.1, p =.078). The odds of reporting a clinically relevant reduction in EQ-5D scores showed seasonal variation, being lowest in summer (OR = 0.48 relative to spring, p =.037). In patients with liver transplant, HRQoL outcomes were comparable to the Dutch general population. Conclusions: PSC patients report impaired HRQoL of small clinical relevance compared with the general population. After liver transplantation, HRQoL scores are at comparable levels to the general population. HRQoL scores are associated with potentially modifiable factors such as itch and IBD activity.
KW - health-related quality of life
KW - inflammatory bowel disease
KW - population-based cohort
KW - post-transplant
KW - primary sclerosing cholangitis
KW - repeated measurements
UR - http://www.scopus.com/inward/record.url?scp=85149419126&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/liv.15542
DO - https://doi.org/10.1111/liv.15542
M3 - Article
C2 - 36779848
SN - 1478-3223
VL - 43
SP - 1056
EP - 1067
JO - Liver international
JF - Liver international
IS - 5
ER -