P623 Quality of life as predictor of biological levels decay in inflammatory bowel diseases. (16th January 2018)

• Record Type: Journal Article
• Authors: Ceballos, D; Fiuza, M D; Alarcón, I
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S424
• Page End: S425
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.750
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Inflammatory bowel disease (IBD) is characterised by the presence of inflammatory lesions of autoimmune origin in the digestive tract. It has been suggested that a possible predictive factor of treatment response could be the level of anti-TNFα antibodies. The objective of this study was the measurement of the level of adalimumab and infliximab and its relationship with activity indexes and quality of life. Methods: Prospective observational study that included adult patients with Crohn's disease (CD) and ulcerative colitis (UC) under active treatment with IFX or ADA in clinical practice. The study protocol was approved by the Dr Negrín Hospital Ethics Committee. The variables analysed were CDAI, Harvey Bradshaw Index, modified Truelove-Witts, Partial Mayo Scoring index, and IBDQ for quality of life. Results: Ninety-six patients met the inclusion criteria and were enrolled into the study (87, 5% CD; 12, 5% UC). The main reason for the therapeutic indication was luminal disease refractory to immunomodulators (IMM) in 47 (49%) cases, intolerance to IMM in 27 (28, 1%) and 8 patients had had a severe onset (8, 3%). In relation to the drug that was used, 44 patients (45, 8%) were started on IFX while 52 on ADA. Immunosuppressive co-treatment was needed in 26 subjects (27.1%) and in 22 (22.9%) the treatment was intensified. There were not statistically significant differences for the CDAI in the peak of drug level vs. valley p = 0.11, Harvey-Bradshaw score p = 0.35, Truelove-Witts test p = 0.72 and Partial Mayo index p = 0.41. In contrast, concerning the quality of life assessment using the IBDQ, there were statistically significant differences in the total score: at the peak moment 205.50 (IQR 45.50) vs. valley moment 200 (59.50), p = 0.002. Also in four out of five subscales of the test: bowel symptoms subscale 5.87 (1.44) vs. 5.50 (1.69) p < 0.001; systemic symptoms subscale 5.35 (1.57) vs. 5.28 (1.71) p = 0.023; functional impairment subscale 5.85 (1.86) vs. 5.57 (2.1) p = 0.01; and emotional function 5.62 (2.06) vs. 5.0 (2.3) p = 0.03 for peak and valley moments, respectively. Conclusions: This study shows that the decrease in drug level correlates with a decrease in the quality of life. There is a discrepancy between those results and the common clinical activity indexes, where there were not statistically significant differences among both periods.