P2154 - Prevalence of Bowel Urgency and Its Associations with Quality of Life in a Real-World Ulcerative Colitis Population: Results from the Measuring Urgency Symptoms in Inflammatory Bowel Disease Collaboration (MUSIC) Study
Millie D. Long, MD, MPH1, Theresa Hunter Gibble, PhD, MPH2, Angela Dobes, MPH3, Laura Weisbein, PhD4, Xian Zhang, PhD4, Wenli Chen, MA, MS4, Richard E. Moses, DO, JD2 1UNC Chapel Hill, Chapel Hill, NC; 2Eli Lilly and Company, Indianapolis, IN; 3Crohn’s and Colitis Foundation, New York, NY; 4University of North Carolina at Chapel Hill, Chapel Hill, NC
Introduction: In patients with ulcerative colitis (UC), clinical trials often focus on disease activity measures such as rectal bleeding and stool frequency. Patients with UC frequently experience bowel urgency (BU), yet less is known about the prevalence of BU and its association with quality of life (QoL) in real-world population.
Methods: In this cross-sectional study from the nationwide inflammatory bowel disease (IBD) Partners cohort, BU was measured utilizing the validated 11-point Urgency Numeric Rating Scale (NRS)1. Scores were categorized into “no or minimal” BU (Urgency NRS 0-1) vs. BU (Urgency NRS 2-10). Remission was measured utilizing the Simple Clinical Colitis Activity Index (SCCAI). QoL measures included Patient Reported Outcome Measurement Information System (PROMIS) measures of depression, anxiety, pain interference, sleep disturbance, fatigue, and social satisfaction via T-scores. Bivariate analyses were utilized to compare categorical variables by urgency. Correlations were performed utilizing Pearson and Spearman rank as appropriate.
Results: Among 884 patients with UC, 44% reported BU. Rates of BU were higher among patients with active disease as compared to those with remission (77% vs. 28%, p< 0.001). No other demographic or disease factors were associated with BU. Use of biologic therapies and steroids were associated with higher rates of BU (Table). Patients with BU had significantly higher rates of depression (23% vs. 13%, p< 0.001), anxiety (36% vs. 21%, p< 0.001), pain interference (38% vs. 21%, p< 0.001), sleep disturbance (26% vs. 14%, p< 0.001), fatigue (42% vs. 19%, p< 0.001) and worse social satisfaction (41% vs. 21%, p< 0.001; Figure). In a sub-analysis of those in remission, BU continued to be significantly associated with fatigue (p=0.03). BU was strongly correlated with disease activity (r=0.62) and weakly correlated with PROMIS measures (r=0.20-0.31).
Discussion: Bowel urgency is common in this real-world UC population, with profound effects on important quality of life measures. Bowel urgency is strongly associated with disease activity in ulcerative colitis.
Figure: Figure: Associations between bowel urgency and PROMIS measures in the UC population. N, Total number of patients; n, number of patients in the subgroups; PROMIS, Patient-Reported Outcomes Measurement Information System; UC, ulcerative colitis. PROs measured by PROMIS T-scores, dichotomized at ≥55 or ≤45 for each measure as appropriate. Urgency measured using 11-point validated Urgency NRS, 0-1=No or minimal bowel urgency, 2-10=bowel urgency. p-value was measured by chi-square test.
Theresa Hunter Gibble: Eli Lilly and Company – Employee, stockholder.
Angela Dobes indicated no relevant financial relationships.
Laura Weisbein indicated no relevant financial relationships.
Xian Zhang indicated no relevant financial relationships.
Wenli Chen indicated no relevant financial relationships.
Richard E. Moses: Eli Lilly and Company – Employee, Stock-privately held company.
Millie D. Long, MD, MPH1, Theresa Hunter Gibble, PhD, MPH2, Angela Dobes, MPH3, Laura Weisbein, PhD4, Xian Zhang, PhD4, Wenli Chen, MA, MS4, Richard E. Moses, DO, JD2. P2154 - Prevalence of Bowel Urgency and Its Associations with Quality of Life in a Real-World Ulcerative Colitis Population: Results from the Measuring Urgency Symptoms in Inflammatory Bowel Disease Collaboration (MUSIC) Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
