title: Does primary sclerosing cholangitis impact quality of life in patients with inflammatory bowel disease?
abstract: 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.
authors.affiliation: Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53227, USA.
authors.forename: Ashwin N
authors.initials: AN
authors.lastname: Ananthakrishnan
authors.forename: Dawn B
authors.initials: DB
authors.lastname: Beaulieu
authors.forename: Alex
authors.initials: A
authors.lastname: Ulitsky
authors.forename: Yelena
authors.initials: Y
authors.lastname: Zadvornova
authors.forename: Sue
authors.initials: S
authors.lastname: Skaros
authors.forename: Kathryn
authors.initials: K
authors.lastname: Johnson
authors.forename: Amar
authors.initials: A
authors.lastname: Naik
authors.forename: Lilani
authors.initials: L
authors.lastname: Perera
authors.forename: Mazen
authors.initials: M
authors.lastname: Issa
authors.forename: David G
authors.initials: DG
authors.lastname: Binion
authors.forename: Kia
authors.initials: K
authors.lastname: Saeian
mesh_terms: 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