Sustained improvement of health-related quality of life in Crohn's disease patients treated with infliximab and azathioprine for 4 years.
BACKGROUND
Infliximab induces remission and improves the health-related quality of life (HRQOL) of patients with refractory or fistulous Crohn's disease (CD). However, little information is available as to whether its effect on HRQOL is sustained over time. The objective was to measure the HRQOL of CD patients in long-term clinical remission.


METHODS
Prospective, observational study was undertaken in patients with CD in infliximab-induced clinical remission (Harvey index <3) for at least 6 months, and receiving long-term infliximab and azathioprine maintenance therapy. Patients were followed for 4 years or until clinical relapse (Harvey index >3). HRQOL was assessed annually using the validated Spanish version of the disease-specific 36-item Inflammatory Bowel Disease Questionnaire (IBDQ-36) and the EuroQol-5D.


RESULTS
Forty-nine patients with CD in stable clinical remission were included at baseline. At 12 months, n = 42 patients remained in remission, at 24 months n = 32 patients, at 36 months n = 13, and in the last visit at 48 months 6 patients remained in clinical remission. The overall score on the IBDQ-36 remained unchanged in patients with stable, inactive CD (median overall score of 6.1 at baseline and 6.5 at 4 years). Scores on all 5 dimensions of the IBDQ-36 remained unchanged over the study period in stable patients. Patients in remission scored highly on the preference value ratings of the EuroQol-5D (scores of 1.0) and remained unchanged in patients who remained in remission.


CONCLUSIONS
Sustained clinical remission of CD achieved with maintenance treatment maintains HRQOL over long-term follow-up.
Casellas
Francesc
F
Unitat d'Atenció Crohn-Colitis from Hospital Universitari Vall d' Hebron, Spain. fcasellas@vhebron.net
Rodrigo
Luis
L
Niño
Pilar
P
Pantiga
Carmen
C
Riestra
Sabino
S
Malagelada
Juan-Ramon
JR
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012074:Remission Induction / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
D000911:Antibodies, Monoclonal; D000069285:Infliximab; D001379:Azathioprine