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Predictive value of early restoration of quality of life in C rohn's disease patients receiving antitumor necrosis factor agents
Author(s) -
HerreradeGuise Claudia,
Casellas Francesc,
Robles Virginia,
Navarro Ester,
Borruel Natalia
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12803
Subject(s) - medicine , quality of life (healthcare) , disease , health related quality of life , retrospective cohort study , tumor necrosis factor alpha , surgery , nursing
Background and Aim C rohn's disease ( CD ) impairs patients' health‐related quality of life ( HRQoL ), therefore a goal of treatment is to improve their health. Recently, a more ambitious therapeutic target has been proposed, to reestablish patients' HRQoL to normal standards. There is no information on long‐term prognostic value of restoring the health of patients with CD . Our aim was to determine if early restoration of HRQoL with antitumor necrosis factor (anti‐ TNF ) agents is associated with long‐term clinical remission. Methods Retrospective longitudinal study in patients with active CD treated with anti‐ TNF agents. Patients completed the I nflammatory B owel D isease Q uestionnaire ( IBDQ )‐36 at baseline and weeks 2, 6, 14, 28, and 52. Early restoration of health was defined as an IBDQ ‐36 score > 209 at week14, and long‐term clinical remission as a C ohn's disease activity index ( CDAI ) score < 150 maintained through week 52. Results Ninety‐four patients were included. Sixty‐three patients maintained long‐term remission, with 47 (75%) of them achieving early restoration of HRQoL . Of the 31 patients who did not maintain long‐term remission, only 4 (13%) restored their HRQoL early ( P < 0.01). There was a strong negative correlation between the IBDQ ‐36 at week14 and CDAI values at week 52 (rs = − 0.64, P < 0.01). Ninety‐two percent of patients with early restoration of HRQoL maintained long‐term remission versus 37% who did not restore their HRQoL ( P < 0.01). To predict long‐term remission, the cutoff point of 209 of the early IBDQ ‐36 had an area under the receiver operating characteristic (AUROC) curve of 0.87. Conclusion Achieving early restoration of HRQoL with anti‐ TNF agents is associated with sustained long‐term remission. This could be a therapeutic goal of treatment in clinical trials and daily practice.