Mallory Chavannes, MD, MHSc1, Theresa Hunter Gibble, PhD, MPH2, Hannah Knight, MSc3, Vanda Palace, MSc3, Sophie Barlow, MSc3, Sylvie Bradesi, PhD2, Hemangi N. Rawal, MPH2, Wendy J. Komocsar, BS2 1Children’s Hospital Los Angeles, Los Angeles, CA; 2Eli Lilly and Company, Indianapolis, IN; 3Adelphi Real World, Bollington, England, United Kingdom
Introduction: Bowel urgency (BU) is a bothersome symptom that impacts quality of life (QoL) in patients with ulcerative colitis (UC).1 This real-world study assessed clinical burden and impact of BU on QoL among pediatric patients with UC.
Methods: Data from the Adelphi Real World Pediatric IBD Disease Specific Programme™, a cross-sectional survey of gastroenterologists and their pediatric patients with UC (aged 2-17 years) in Germany, Spain, France, Italy, Japan, the UK, and the US were analyzed. Data for demographics and clinical characteristics were collected via physician-completed patient record forms and data for QoL were collected via patient-self completion forms for patients aged 12-17 years. Caregivers completed the forms for patients aged 2-11 years. Two patient subgroups were identified: patients with BU and patients without BU. Disease activity was assessed using pediatric UC Activity Index (PUCAI) and total Mayo scores. Work Productivity and Activity Impairment (WPAI) and IMPACT III questionnaires were used to assess the impact on classroom and daily activity, and QoL. Fisher’s exact test, Chi-square, and Mann-Whitney tests were used to compare groups, as appropriate.
Results: Of 1162 patients (mean age:12.9 years), BU was reported in 13.8% (n=160) patients. Patients with BU had a more severe disease compared to those without BU. Higher PUCAI (p< 0.0001) and total Mayo scores (p=0.0003) were observed in patients with BU vs those without BU. Patients with BU were more likely to have abdominal distension, abdominal pain, anal discharge, anemia, diarrhea (with or without blood), and fatigue compared to patients without BU. At the time of survey, a greater proportion of patients with BU experienced flares compared to those without BU (26.2% vs 15.5%, p=0.0138). Higher rates of hospitalizations were observed in patients with BU compared to those without BU (46.7% vs 25.4%, p< 0.0001). Higher impairment in conducting normal daily activities (p< 0.0001) and in the ability to go to school/nursery (p< 0.0001) were observed in patients with BU vs patients without BU. Higher WPAI scores for overall classroom impairment and activity impairment were observed in patients with BU (Table). Patients with BU had lower scores in all domains of IMPACT III questionnaire (Figure).
Discussion: Our study showed that BU is associated with higher disease activity, increased impairment in normal daily activities, and worsened QoL in pediatric patients with UC.
1Dubinsky MC, et al. Crohn's & Colitis 360. 2022;4(3).
Figure: Figure: Domains of IMPACT III scores in pediatric patients with and without bowel urgency. The single domain scores range from 0 to 100, with 0 indicating the lowest health-related quality of life and 100 indicating the highest. The sample sizes varied in the survey since the questionnaire was completed on a voluntary basis, and hence patients/caregivers were not mandated to answer all the questions. Error bars show standard deviation. n, number of patients in the subgroups.
Disclosures:
Mallory Chavannes: Prometheus Laboratories Inc. – Consultant.
Theresa Hunter Gibble: Eli Lilly and Company – Employee, stockholder.
Hannah Knight indicated no relevant financial relationships.
Vanda Palace indicated no relevant financial relationships.
Sophie Barlow indicated no relevant financial relationships.
Sylvie Bradesi: Eli Lilly and Company – Employee, Stock Options.
Hemangi Rawal: Eli Lilly and Company – Employee, Stock Options.
Wendy J. Komocsar: Eli Lilly and Company – Employee, Stock Options.
Mallory Chavannes, MD, MHSc1, Theresa Hunter Gibble, PhD, MPH2, Hannah Knight, MSc3, Vanda Palace, MSc3, Sophie Barlow, MSc3, Sylvie Bradesi, PhD2, Hemangi N. Rawal, MPH2, Wendy J. Komocsar, BS2. P2194 - Burden of Bowel Urgency Among Pediatric Patients with Ulcerative Colitis: Results from a Physician and Patient Survey, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
