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Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis
BACKGROUND: Associations between patient‐reported outcomes and mucosal healing have not been established in ulcerative colitis (UC). AIM: To evaluate relationships of rectal bleeding and stool frequency with mucosal healing and quality of life (QoL) in patients with UC in two Phase 3 studies (ULTRA...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049645/ https://www.ncbi.nlm.nih.gov/pubmed/26381802 http://dx.doi.org/10.1111/apt.13387 |
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author | Jharap, B. Sandborn, W. J. Reinisch, W. D'Haens, G. Robinson, A. M. Wang, W. Huang, B. Lazar, A. Thakkar, R. B. Colombel, J.‐F. |
author_facet | Jharap, B. Sandborn, W. J. Reinisch, W. D'Haens, G. Robinson, A. M. Wang, W. Huang, B. Lazar, A. Thakkar, R. B. Colombel, J.‐F. |
author_sort | Jharap, B. |
collection | PubMed |
description | BACKGROUND: Associations between patient‐reported outcomes and mucosal healing have not been established in ulcerative colitis (UC). AIM: To evaluate relationships of rectal bleeding and stool frequency with mucosal healing and quality of life (QoL) in patients with UC in two Phase 3 studies (ULTRA 1 and 2). METHODS: Associations of patient‐reported rectal bleeding and stool frequency subscores with mucosal healing (Mayo endoscopy subscore = 0 or 0/1) and QoL [inflammatory bowel disease questionnaire (IBDQ)] were assessed in adalimumab‐randomised patients (160/80 mg at Weeks 0/2 followed by 40 mg biweekly or weekly) at Weeks 8 (n = 433) and 52 (n = 299), and in patients with mucosal healing [endoscopy subscore = 0 (n = 17); 0/1 (n = 52)] at Weeks 8 and 52. RESULTS: At Week 8, the positive predictive values (PPVs) of rectal bleeding subscore = 0, stool frequency subscore = 0 or both scores = 0 for endoscopy subscore = 0/1 were 69%, 84% and 90% respectively; all proportions increased at Week 52. Equivalent PPVs for these subscores in patients with endoscopy subscore = 0 were 26%, 37% and 46% respectively. Among patients with endoscopy subscore = 0 at Week 8, 87% reported no rectal bleeding, while only 29% reported normal stool frequency; these proportions had increased to 94% and 41% respectively, at Week 52. Among patients with mucosal healing, IBDQ scores trended highest for patients with both rectal bleeding and stool frequency subscores = 0. CONCLUSIONS: Absence of rectal bleeding and normal stool frequency are often predictive of mucosal healing and QoL, but complete normalisation of stool frequency is encountered rarely in patients with mucosal healing. |
format | Online Article Text |
id | pubmed-5049645 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-50496452016-10-06 Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis Jharap, B. Sandborn, W. J. Reinisch, W. D'Haens, G. Robinson, A. M. Wang, W. Huang, B. Lazar, A. Thakkar, R. B. Colombel, J.‐F. Aliment Pharmacol Ther Randomised Clinical Study BACKGROUND: Associations between patient‐reported outcomes and mucosal healing have not been established in ulcerative colitis (UC). AIM: To evaluate relationships of rectal bleeding and stool frequency with mucosal healing and quality of life (QoL) in patients with UC in two Phase 3 studies (ULTRA 1 and 2). METHODS: Associations of patient‐reported rectal bleeding and stool frequency subscores with mucosal healing (Mayo endoscopy subscore = 0 or 0/1) and QoL [inflammatory bowel disease questionnaire (IBDQ)] were assessed in adalimumab‐randomised patients (160/80 mg at Weeks 0/2 followed by 40 mg biweekly or weekly) at Weeks 8 (n = 433) and 52 (n = 299), and in patients with mucosal healing [endoscopy subscore = 0 (n = 17); 0/1 (n = 52)] at Weeks 8 and 52. RESULTS: At Week 8, the positive predictive values (PPVs) of rectal bleeding subscore = 0, stool frequency subscore = 0 or both scores = 0 for endoscopy subscore = 0/1 were 69%, 84% and 90% respectively; all proportions increased at Week 52. Equivalent PPVs for these subscores in patients with endoscopy subscore = 0 were 26%, 37% and 46% respectively. Among patients with endoscopy subscore = 0 at Week 8, 87% reported no rectal bleeding, while only 29% reported normal stool frequency; these proportions had increased to 94% and 41% respectively, at Week 52. Among patients with mucosal healing, IBDQ scores trended highest for patients with both rectal bleeding and stool frequency subscores = 0. CONCLUSIONS: Absence of rectal bleeding and normal stool frequency are often predictive of mucosal healing and QoL, but complete normalisation of stool frequency is encountered rarely in patients with mucosal healing. John Wiley and Sons Inc. 2015-09-03 2015-11 /pmc/articles/PMC5049645/ /pubmed/26381802 http://dx.doi.org/10.1111/apt.13387 Text en © 2015 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Randomised Clinical Study Jharap, B. Sandborn, W. J. Reinisch, W. D'Haens, G. Robinson, A. M. Wang, W. Huang, B. Lazar, A. Thakkar, R. B. Colombel, J.‐F. Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title | Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title_full | Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title_fullStr | Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title_full_unstemmed | Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title_short | Randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
title_sort | randomised clinical study: discrepancies between patient‐reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis |
topic | Randomised Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049645/ https://www.ncbi.nlm.nih.gov/pubmed/26381802 http://dx.doi.org/10.1111/apt.13387 |
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