Icahn School of Medicine Mount Sinai, New York, NY, USA.
QualityMetric Incorporated, LLC, Johnston, RI, USA.
Inflamm Bowel Dis. 2024 Nov 4;30(11):2115-2126. doi: 10.1093/ibd/izad282.
Previous reviews produced weak evidence regarding the responsiveness of the Inflammatory Bowel Disease Questionnaire (IBDQ-32) to changes in ulcerative colitis (UC) health indicators. This systematic review and meta-analysis provide an updated synthesis on IBDQ-32 responsiveness.
A systematic literature review identified 11 articles reporting IBDQ-32 responder analyses in randomized control trials, which were included in a random effects meta-analysis, and 15 articles linking IBDQ-32 change to change in UC health indicators, which were summarized narratively. Meta-analysis compared differences between IBDQ-32 responder proportions in efficacious and nonefficacious treatment arms relative to placebo. Linear meta-regression examined the association of treatment efficacy and proportions of IBDQ-32 responders in active treatment compared with placebo.
Meta-analysis showed larger differences in IBDQ-32 response proportions between active treatment and placebo for efficacious treatments (pooled OR, 2.19; 95% CI, 1.83-2.63) than nonefficacious treatments (pooled OR, 1.21; 95% CI, 0.84-1.74; Cochran's Q[df = 1] = 8.26, P = .004). Meta-regression showed that the magnitude of treatment efficacy positively predicted IBDQ-32 response in active treatments relative to placebo (β = 0.21, P < .001). Moderate to strong correlations were found between change in IBDQ-32 and change in health indicators (eg, patient-reported measures, disease activity, endoscopic indices; correlations, 0.37-0.64 in absolute values). Patients achieving clinical response or remission showed greater change in IBDQ-32 total scores (range, 22.3-50.1 points) and more frequently met clinically meaningful thresholds on the IBDQ-32 than those not achieving clinical response or remission (all P < .05).
The IBDQ-32 is responsive to changes in UC health indicators and disease activity, including in response to efficacious treatment (relative to placebo).
先前的综述结果表明，在溃疡性结肠炎（UC）健康指标的变化方面，炎症性肠病问卷（IBDQ-32）的反应性证据较弱。本系统综述和荟萃分析提供了关于 IBDQ-32 反应性的最新综合结果。
系统文献检索确定了 11 篇报告随机对照试验中 IBDQ-32 应答分析的文章，这些文章被纳入随机效应荟萃分析，并总结了 15 篇将 IBDQ-32 变化与 UC 健康指标变化联系起来的文章。荟萃分析比较了有效治疗组和无效治疗组与安慰剂组之间 IBDQ-32 应答者比例的差异。线性荟萃回归分析了治疗效果和与安慰剂相比，活性治疗中 IBDQ-32 应答者比例之间的关系。
荟萃分析显示，在有效治疗组（汇总 OR，2.19；95%CI，1.83-2.63）与安慰剂组之间，IBDQ-32 应答比例的差异大于无效治疗组（汇总 OR，1.21；95%CI，0.84-1.74；Cochran's Q[df=1]=8.26，P=0.004）。荟萃回归显示，与安慰剂相比，治疗效果的大小与活性治疗中 IBDQ-32 应答呈正相关（β=0.21，P<.001）。IBDQ-32 的变化与健康指标的变化（例如，患者报告的测量、疾病活动、内镜指数）之间存在中度至高度相关性（绝对值相关性为 0.37-0.64）。达到临床缓解或缓解的患者在 IBDQ-32 总分上有更大的变化（范围为 22.3-50.1 分），并且比未达到临床缓解或缓解的患者更频繁地达到 IBDQ-32 的临床有意义阈值（均 P<.05）。
IBDQ-32 对 UC 健康指标和疾病活动的变化敏感，包括对有效治疗（相对于安慰剂）的反应。
