Center for Gastrointestinal Biology & Disease, University of North Carolina, Chapel Hill, North Carolina, USA.
Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Am J Gastroenterol. 2018 Jan;113(1):72-79. doi: 10.1038/ajg.2017.240. Epub 2017 Aug 29.
Patient reported outcomes (PROs) are important treatment endpoints in inflammatory bowel diseases (IBD). We evaluated the gastrointestinal (GI) PRO Measurement Information System (PROMIS) in IBD subjects.
Crohn's and Colitis Foundation of America's Partners is an Internet-based cohort of IBD subjects. Participants complete surveys, including demographics, disease characteristics, PROMIS domains, disease activity (short Crohn's disease activity index or simple clinical colitis activity index) and quality of life (QoL) indices. In a nested cross-sectional study, we used univariate and bivariate analyses to assess associations between 8 GI-PROMIS domains (reflux, swallowing, diarrhea, nausea, belly pain, gas, incontinence, and constipation) and QoL and disease activity indices.
The study included 2,378 Crohn's Disease (CD) and 1,455 ulcerative colitis (UC) respondents with a median age of 41 years. Median disease duration was 11 years for CD subjects and 8 years for UC subjects; 57% of CD subjects and 42% of UC subjects were in remission. Among symptomatic CD subjects, those with active CD reported significantly worse symptoms on all 8 domains than those in remission. The same was observed for UC subjects with the exception of disrupted swallowing. IBD subjects with worse QoL reported significantly worse symptoms on all 8 domains compared to those with better QoL.
In IBD subjects experiencing GI symptoms, GI-PROMIS domains were strongly associated with disease activity and QoL indices. GI-PROMIS holds potential as PRO measures in IBD and correlates with other validated indices in this population.
患者报告的结局(PROs)是炎症性肠病(IBD)的重要治疗终点。我们评估了 IBD 患者的胃肠道(GI)PRO 测量信息系统(PROMIS)。
美国克罗恩病和结肠炎基金会的合作伙伴是一个基于互联网的 IBD 患者队列。参与者完成调查,包括人口统计学、疾病特征、PROMIS 领域、疾病活动(简短的克罗恩病活动指数或简单的临床结肠炎活动指数)和生活质量(QoL)指数。在一项嵌套的横断面研究中,我们使用单变量和双变量分析来评估 8 个 GI-PROMIS 领域(反流、吞咽、腹泻、恶心、腹痛、气体、失禁和便秘)与 QoL 和疾病活动指数之间的关联。
该研究包括 2378 名克罗恩病(CD)和 1455 名溃疡性结肠炎(UC)患者,中位年龄为 41 岁。CD 患者的中位疾病持续时间为 11 年,UC 患者的中位疾病持续时间为 8 年;57%的 CD 患者和 42%的 UC 患者处于缓解状态。在有症状的 CD 患者中,活动期 CD 患者在所有 8 个领域的症状明显比缓解期患者更差。UC 患者也观察到了同样的情况,除了吞咽障碍。与生活质量较好的患者相比,生活质量较差的 IBD 患者在所有 8 个领域的症状都明显更差。
在经历 GI 症状的 IBD 患者中,GI-PROMIS 领域与疾病活动和 QoL 指数密切相关。GI-PROMIS 作为 IBD 的 PRO 测量具有潜力,并与该人群中的其他经过验证的指数相关。