Key result
Even mild active ulcerative colitis is linked to worse quality of life and productivity versus remission.
Why the study?
The study was conducted to comprehensively explore the impacts of symptom severity and proctocolectomy on nine patient-reported outcomes in patients with ulcerative colitis.
Does active disease symptom severity or proctocolectomy worsen patient-reported outcomes compared to remission in patients with ulcerative colitis?
Cross-Sectional (n=1,971)
Yes
Does active disease symptom severity or proctocolectomy worsen patient-reported outcomes compared to remission in patients with ulcerative colitis?
In patients with ulcerative colitis, even mild active symptoms or a history of proctocolectomy are associated with significantly worse patient-reported outcomes across multiple domains compared to clinical remission.
Even mild active ulcerative colitis symptoms impair patient-reported outcomes; this cross-sectional association leaves open prospective confirmation before guiding practice.
BACKGROUND: The YOu and Ulcerative colitis: Registry and Social network (YOURS) is a large-scale, multicenter, patient-focused registry investigating the effects of lifestyle, psychological factors, and clinical practice patterns on patient-reported outcomes in patients with ulcerative colitis in Japan. In this initial cross-sectional baseline analysis, we comprehensively explored impacts of symptom severity or proctocolectomy on nine patient-reported outcomes. METHODS: Patients receiving tertiary care at medical institutions were consecutively enrolled in the YOURS registry. The patients completed validated questionnaires on lifestyle, psychosocial factors, and disease-related symptoms. Severity of symptoms was classified with self-graded stool frequency and rectal bleeding scores (categories: remission, active disease [mild, moderate, severe]). The effects of symptom severity or proctocolectomy on nine scales for quality of life, fatigue, anxiety/depression, work productivity, and sleep were assessed by comparing standardized mean differences of the patient-reported outcome scores. RESULTS: Of the 1971 survey responses analyzed, 1346 (68.3%) patients were in remission, 583 (29.6%) had active disease, and 42 (2.1%) had undergone proctocolectomy. A linear relationship between increasing symptom severity and worsening quality of life, fatigue, anxiety, depression, and work productivity was observed. Patients with even mild symptoms had worse scores than patients in remission. Patients who had undergone proctocolectomy also had worse scores than patients in remission. CONCLUSIONS: Ulcerative colitis was associated with reduced mood, quality of life, fatigue, and work productivity even in patients with mild symptoms, suggesting that management of active ulcerative colitis may improve patient-reported outcomes irrespective of disease severity. (UMIN Clinical Trials Registry: UMIN000031995, https://www.umin.ac.jp/ctr/index-j.htm ).
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Matsuoka et al. (2023) conducted a cross-sectional in Ulcerative colitis (n=1,971). Active ulcerative colitis symptoms vs. Clinical remission was evaluated on Patient-reported outcomes (quality of life, fatigue, anxiety/depression, work productivity, and sleep). Active ulcerative colitis was associated with reduced mood, quality of life, fatigue, and work productivity even in patients with mild symptoms compared to those in remission.
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