Camilo Obando, MD, MBA1, Zhijie Ding, PhD, MS1, James Izanec, MD1, Mirko Sikirica, PharmD2, James Lucas3, Jessalyn Kemp3, Erik Muser, PharmD, MPH1
1Janssen Scientific Affairs, LLC, Horsham, PA; 2Janssen Research & Development, LLC, Horsham, PA; 3Adelphi Real World, Bollington, England, United Kingdom
Introduction: Measuring Patient-Reported Outcomes (PROs) is important in understanding how Crohn’s disease (CD) patients perceive their own health status and emotional well-being. This study aims to establish the association between PROs and the Crohn’s Disease Activity Index (CDAI) using real-world data.
Methods: Data were drawn from the Adelphi Disease Specific Programme, a real-world survey of gastroenterologist-completed retrospective chart reviews and patient self-completed questionnaires conducted in the US in 2015 and 2017. CD patients self-completed a form containing the EQ-5D and the SIBDQ. Comparisons between patients with a CDAI of 0-150 (remission), 151-220 (mild) and >220 (moderate to severe [mod/sev]) at the time of the survey were made using Kruskal-Wallis and Chi-squared tests for continuous and categorical variables, respectively.
Results: Of the 468 CD patients included, 291 were in remission, 105 mild and 72 mod/sev. Patients had a mean duration of 7.5 (remission), 6.9 (mild) and 5.5 (mod/sev) years since diagnosis, respectively (p=0.055). There was no significant difference in mean age or gender distribution amongst disease severity states. 13.8% of remission patients, 26.9% mild and 48.0% of mod/sev were currently experiencing a flare or flare-like symptom (p< 0.001). Remission patients had a higher mean overall SIBDQ score compared with mild and mod/sev (table 1), and higher subdomain scores of systemic, social, bowel and emotional score, respectively (table 1). Remission patients had higher mean EQ-5D and EQ-5D VAS scores compared with mild and mod/sev, and reported lower impact on usual activities, social care, and mobility, as well as lower levels of pain/discomfort and anxiety/depression in the EQ-5D subdomains (table 2).
Discussion: CD patients with more severe disease according to the CDAI self-reported lower quality of life in terms of mean overall SIBDQ score and across all subdomains compared to mild patients and patients in remission. Patients with more severe disease were also more likely to report lower mean EQ-5D score, particularly in the subdomains of social care, usual activities, pain/discomfort, and anxiety/depression, compared to mild patients and patients in remission. Physicians reported percentages of patients currently experiencing a flare-like symptom may present an opportunity to further improve disease control for all subgroups of patients.
Citation: Camilo Obando, MD, MBA; Zhijie Ding, PhD, MS; James Izanec, MD; Mirko Sikirica, PharmD; James Lucas; Jessalyn Kemp; Erik Muser, PharmD, MPH. P1408 - RELATIONSHIP BETWEEN CROHN’S DISEASE ACTIVITY INDEX AND PATIENT-REPORTED OUTCOMES FOR CROHN’S DISEASE PATIENTS IN THE UNITED STATES. Program No. P1408. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.