Self-reported Symptom Burden in Individuals with Inflammatory Bowel Disease

Farrell, Dawn; McCarthy, Geraldine; Savage, Eileen

doi:10.1093/ecco-jcc/jjv218

Cited by 115 publications

(98 citation statements)

References 44 publications

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“…One single-center cross-sectional study showed that fatigue has an inverse relationship with clinical and endoscopic remission, and that deep remission has lower rates of fatigue complaints compared to clinical remission only [7]. In another cross-sectional study of 247 patients with IBD, lack of energy was the most burdensome symptom, more so than gastrointestinal complaints, such as diarrhea [8]. Fatigue occurs in patients with IBD of all ages and both sexes, although some studies suggest a greater burden in women [9].…”

Section: Introductionmentioning

confidence: 99%

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

et al. 2019

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Fatigue is a burdensome, multidimensional, and multifactorial symptom that is associated with a wide array of chronic illnesses, specifically occurring in nearly 50% of patients with inflammatory bowel disease (IBD). Although common, given its subjective nature, physicians often under-recognize and undertreat this debilitating symptom. There are multiple etiologies that can contribute to fatigue in patients with IBD, including disease activity, anemia, medications, psychosomatic symptoms, and alterations to the gut-brain axis. The management of fatigue in IBD can be challenging, as it is often times multifaceted. In this review, we summarize the available tools for the diagnosis and measurement of fatigue, discuss etiologies, and make recommendations for their management. We identify knowledge gaps for the workup and treatment of fatigue and propose an algorithm to aid physicians in the evaluation and management of fatigue in this unique population. However, future research is needed to address several areas of knowledge deficits and improve the management of fatigue in IBD.

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Section: Introductionmentioning

confidence: 99%

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

et al. 2019

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“…Common IBD symptoms may include diarrhea, abdominal pain, gastrointestinal bleeding, weight loss, and psychological distress. 1 – 3 CD and UC patients experience periods of remission and relapse, the latter generally triggered by environmental factors and characterized by intensification of symptoms. 4 …”

Section: Introductionmentioning

confidence: 99%

Inflammatory bowel disease patients prioritize mucosal healing, symptom control, and pain when choosing therapies: results of a prospective cross-sectional willingness-to-pay study

Gregor¹,

Williamson²,

Dajnowiec³

et al. 2018

PPA

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BackgroundGiven the large armamentarium of therapies for inflammatory bowel disease (IBD), physicians cannot fully describe all treatments to patients and, therefore, make assumptions regarding treatment attributes communicated to patients. This study aimed to assess out-of-pocket willingness-to-pay that IBD patients allocate to treatment attributes.MethodsAdult patients receiving therapy for IBD were invited to access a cross-sectional web-based discrete-choice experiment (May 22–August 31, 2015) that presented paired medication scenarios with varying efficacy, safety, and administration parameters. Preference weights and willingness-to-pay for each attribute level were assessed by a hierarchical Bayes method including a multinomial logit model.ResultsA total of 586 IBD patients were included, 404 (68.9%) with Crohn’s disease and 182 (31.1%) with ulcerative colitis. Genders were evenly distributed; the majority of patients (70.1%) were 50 years or younger and had postsecondary education (75.4%), while the median health status was 7 (Likert scale: 1 [poor] – 10 [perfect]). Regarding relative preference-weight estimates, for the average respondent, reducing pain during administration, mucosal healing, and symptom relief were the highest-ranking attributes. Conversely, infusion reactions and risk of hospitalization or surgery were the lowest-ranking attributes. In multivariate analysis, patient sociodemographics did not affect the rank order of attributes although small differences were observed between asymptomatic and symptomatic patients in the previous year.ConclusionThis study has important implications related to understanding patient preferences and designing patient-centered strategies. IBD patients prioritize treatments with low administration pain. Additionally, these results concur with treatment guidelines emphasizing patients’ preference for mucosal healing and symptom control.

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“…Ulcerative colitis is a chronic, idiopathic, and diffuse inflammatory condition 1 with clinical symptoms including bloody diarrhea, bowel urgency, hematochezia, abdominal pain, and lack of energy. 2,3 Inflammatory bowel diseases (IBDs) such as ulcerative colitis are thought to result from overly aggressive T-cellmediated immune responses to commensal bacteria in the gut, resulting in injury to the digestive tract. 2,4 Various factors may interact to cause this inappropriate T-cell response, including genetic susceptibility of patients, the population of bacteria in the intestinal lumen, and environmental triggers such as the use of nonsteroidal, anti-inflammatory drugs.…”

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confidence: 99%

A Phase 1, Multiple‐Dose Study of Vedolizumab in Japanese Patients With Ulcerative Colitis

Kobayashi

Suzuki

Watanabe

et al. 2018

The Journal of Clinical Pharma

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Although previous studies have shown that patients with ulcerative colitis may benefit from treatment with vedolizumab, a humanized monoclonal antibody targeting the α β integrin heterodimer, no data exist in Japanese populations. The aim of this phase 1, open-label, multicenter study was to assess the pharmacokinetics, pharmacodynamics, efficacy, and safety of vedolizumab in Japanese patients with ulcerative colitis. Adult patients with confirmed ulcerative colitis received either 150 mg (step 1) or 300 mg (step 2) of intravenous (IV) vedolizumab on days 1, 15, and 43 of the study protocol. Pharmacokinetic, pharmacodynamic, safety, and efficacy parameters were all assessed through study end (day 239). Nine patients were enrolled in this study (150 mg, n = 3; 300 mg, n = 6). Patients who received vedolizumab IV 300 mg had approximately twice the drug exposure of those receiving vedolizumab IV 150 mg (day 1 AUC 744 vs 408 μg·d/mL) and a longer-lasting maximal saturation of α β integrin (155 vs 99 days). The number of treatment-emergent adverse events, all of which were mild or moderate in intensity, was similar between the 150-mg (15 events) and 300-mg (20 events) groups. The 2 patients (150 mg group) not in clinical remission by partial Mayo score at the start of the study met the criteria for clinical remission on days 15 and 155 of the study, respectively. In conclusion, in Japanese patients with ulcerative colitis, vedolizumab showed similar pharmacokinetic and pharmacodynamic results to those seen in non-Japanese patients. Vedolizumab was well tolerated and demonstrated clinical activity consistent with previous studies.

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Self-reported Symptom Burden in Individuals with Inflammatory Bowel Disease

Cited by 115 publications

References 44 publications

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Inflammatory bowel disease patients prioritize mucosal healing, symptom control, and pain when choosing therapies: results of a prospective cross-sectional willingness-to-pay study

A Phase 1, Multiple‐Dose Study of Vedolizumab in Japanese Patients With Ulcerative Colitis

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