Does primary sclerosing cholangitis impact quality of life in patients with inflammatory bowel disease?
BACKGROUND
Impairment of health-related quality of life (HRQoL) is an important concern in inflammatory bowel disease (IBD; ulcerative colitis [UC], Crohn's disease [CD]). Between 2%-10% of patients with IBD have primary sclerosing cholangitis (PSC). There has been limited examination of the disease-specific HRQoL in this population compared to non-PSC IBD controls.


METHODS
This was a retrospective, case-control study performed at a tertiary referral center. Cases comprised 26 patients with a known diagnosis of PSC and IBD (17 UC, 9 CD). Three random controls were selected for each case after matching for IBD type, gender, age, and duration of disease. Disease-specific HRQoL was measured using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Disease activity for CD was measured using the Harvey-Bradshaw index (HB) and using the UC activity index for UC. Independent predictors of HRQoL were identified.


RESULTS
There was no significant difference in the age, gender distribution, or disease duration between PSC-IBD and controls. There was no difference in use of immunomodulators or biologics between the 2 groups. Mean SIBDQ score was comparable between PSC-IBD patients (54.5) and controls (54.1), both for UC and CD. Likewise, the disease activity scores were also similar (2.8 versus 3.1, P = 0.35). On multivariate analysis, higher disease activity score (-1.33, 95% confidence interval [CI] 95% CI -1.85 to -0.82) and shorter disease duration were predictive of lower HRQoL. Coexisting PSC did not influence IBD-related HRQoL. There was a higher proportion of permanent work disability in PSC-IBD (7.7%) compared to controls (0%).


CONCLUSIONS
PSC does not seem to influence disease-specific HRQoL in our patients with IBD but is associated with a higher rate of work disability.
Ananthakrishnan
Ashwin N
AN
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53227, USA.
Beaulieu
Dawn B
DB
Ulitsky
Alex
A
Zadvornova
Yelena
Y
Skaros
Sue
S
Johnson
Kathryn
K
Naik
Amar
A
Perera
Lilani
L
Issa
Mazen
M
Binion
David G
DG
Saeian
Kia
K
D000328:Adult; D016022:Case-Control Studies; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000503:physiopathology*; D003093:Colitis, Ulcerative / Q000150:complications* / Q000503:physiopathology*; D003424:Crohn Disease / Q000150:complications* / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011788:Quality of Life; D012189:Retrospective Studies; D018582:Sick Leave