Background Inflammatory bowel diseases (IBD) are chronic inflammatory diseases characterized by inflammation of (a part of) the gastrointestinal tract with a relapsing and remitting course. IBD patients have lower Quality of Life (QoL) than the general population and apart from intestinal symptoms, IBD is associated with a variety of extraintestinal manifestations of which arthropathies are the most common.
Objectives To assess the effect of patient-reported factors on QoL in IBD patients with and without arthropathies, prospectively over 1 year.
Methods In total, 181 IBD patients were questioned about joint pain. At baseline, 135 patients (77% Crohn’s disease (CD), 34% male) had arthropathies (back pain for ≥3 months and/or peripheral joint pain and/or joint swelling during the last year), another 46 patients (74% CD, 50% male) who had no arthropathies served as controls. QoL was assessed by the shortIBDQ and SF-36 (physical (PCS) and mental (MCS) component summary scores). Harvey-Bradshaw Index (HBI) and Simple Clinical Colitis Activity Index (SCCAI) were used to measure IBD activity (active disease if HBI/SCCAI >4). Disease activity and (nocturnal) pain, back and peripheral joints, were scored (11-point numerical rating scale (NRS)). The self-administered questionnaires were assessed every 3-months. Uni- and multivariate (linear mixed model) analyses were performed to investigate which variables (age, gender, type of IBD, IBD duration, IBD activity, 6 NRS scores, smoking and employment) were associated with QoL. Variables with a p<0.20 were included in multivariate analyses. Because of the strong correlation between the 6 NRS scores, we included 2 of 6 scores in the multivariate analyses.
Results The mean age and mean IBD disease duration of all patients (n=181) were 43.6±13.7 and 15.6±11.1 years, respectively. Multivariate analysis showed that an increase in disease activity of the back and an increase in disease activity of the peripheral joints and IBD activity were independently associated with a lower QoL as assessed with shortIBDQ (all p<0.001). Increased IBD duration and employment were independently associated with a better QoL by shortIBDQ (both p<0.05). Back and peripheral joint pain, IBD activity and unemployment were independently associated with worse PCS (all p<0.001). Disease activity of peripheral joints and IBD were independently associated with worse (both p<0.001), and employment and age independently associated with a better MCS (both p<0.05).
Conclusions Arthropathies in IBD significantly negatively impact the QoL. It is important to take this into account in the management of patients with IBD. Furthermore, IBD activity is independently associated with worse QoL; employment, increased IBD duration and age are independently associated with a better QoL.
Disclosure of Interest None Declared