title: Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases.
abstract: Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents.
  
  
  
  This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality.
  
  
  
  Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8, p = 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5, p = 0.009). Parallel reductions in depression and anxiety were also noted (p < 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6.
  
  
  
  Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD.
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
authors: Betsy W
authors: BW
authors: Stevens
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.|University of Groningen, Groningen, The Netherlands.
authors: Nynke Z
authors: NZ
authors: Borren
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
authors: Gabriella
authors: G
authors: Velonias
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
authors: Grace
authors: G
authors: Conway
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
authors: Thom
authors: T
authors: Cleland
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
authors: Elizabeth
authors: E
authors: Andrews
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.|Harvard Medical School, Boston, MA, USA.
authors: Hamed
authors: H
authors: Khalili
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.|Harvard Medical School, Boston, MA, USA.
authors: John G
authors: JG
authors: Garber
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.|Harvard Medical School, Boston, MA, USA.
authors: Ramnik J
authors: RJ
authors: Xavier
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.|Harvard Medical School, Boston, MA, USA.
authors: Vijay
authors: V
authors: Yajnik
authors: Division of Gastroenterology, Massachusetts General Hospital Crohn's and Colitis Centre, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA. aananthakrishnan@mgh.harvard.edu.|Harvard Medical School, Boston, MA, USA. aananthakrishnan@mgh.harvard.edu.
authors: Ashwin N
authors: AN
authors: Ananthakrishnan
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000339:Affect; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000523:psychology; D003424:Crohn Disease / Q000188:drug therapy / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D012890:Sleep; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; C529000:golimumab; C543529:vedolizumab; D000069285:Infliximab; D000068879:Adalimumab; D000068582:Certolizumab Pegol
keywords: Anxiety; Biologics; Depression; Sleep; Vedolizumab