Introduction
Current treatments for Crohn’s disease (CD) and ulcerative colitis (UC) are associated with loss of treatment response. However, studies assessing the real-world burden of non-response in Canada are scarce and the clinical and humanistic burden remains unknown. We aimed to describe the burden of active disease on symptom prevalence and work impairment by describing patients with CD and UC according to remission status.
Aims & Methods
Data were drawn from the Adelphi Real World Inflammatory Bowel Disease Specific Programme™, a real-world, cross-sectional survey of gastroenterologists (GEs) and their consulting patients with CD and UC in Canada from June 2023 to January 2024. Data included physician-reported patient demographics and clinical characteristics. Descriptive analyses were conducted.
Results
19 physicians reported data for 144 patients (73 with CD and 71 with UC). Physicians reported 20% of patients not to be in clinical or endoscopic remission (non-remitters), 31% to be in clinical remission only and 49% in both clinical and endoscopic remission. Mean (standard deviation) age was 44.5 (20.5) years among non-remitting patients, 33.5 (13.3) years among those in clinical remission only and 40.4 (17.4) years among patients in those with clinical and endoscopic remission. Among non-remitting patients, 38% were an ex-smoker, versus 14% of clinical remission and 18% of clinical and endoscopic remission patients. The most reported comorbid conditions included anxiety (24% non-remitters, 14% clinical remitters, 18% clinical and endoscopic remitters), depression (14% non-remitters, 0% in clinical remitters, and 14% in clinical and endoscopic remitters) and hypertension (14% non-remitters, 9% clinical remitters, and 14% clinical and endoscopic remitters). Top three current symptoms included fatigue (52% non-remitters, 32% clinical remitters, 15% clinical and endoscopic remitters), abdominal pain (69% non-remitters, 14% clinical remitters, 7% clinical and endoscopic remitters), and non-bloody diarrhea (48% non-remitters, 7% clinical remitters, 6% clinical and endoscopic remitters). Regarding employment, 38% of non-remitters were working full-time versus 48% of clinical remitters, and 58% of clinical and endoscopic remitters.
Conclusion
Patients with CD/UC that had not achieved or maintained remission experienced more symptom burden, comorbid conditions, and were often not in full-time employment than those in disease remission. Notably, non-remitters experienced a high symptom burden, including fatigue, abdominal pain, and diarrhea, which impacted daily living. Patients with both clinical and endoscopic remission experienced fewer symptoms and full-time employment. This highlights the importance of, and significant unmet need for, effective treatment in IBD to manage disease symptoms and decrease inflammation.
Disclosure
Janssen Global Services funded the research and I am an employee of Janssen
