The effects of thiopurine therapy on health-related quality of life in Inflammatory Bowel Disease patients

Abstract

Background: The effect of thiopurine immunomodulators on health-related quality of life (HRQoL) in patients with inflammatory bowel disease (IBD) has been controversial. The aims were to evaluate the HRQoL in patients with IBD treated with thiopurines and assess the short- and long-term impacts of the treatment on HRQoL.

Methods: Ninety-two consecutive patients who started treatment with thiopurines were prospectively included. Evaluation of HRQoL was performed at months 0, 6, and 12 using two questionnaires, the Short-Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ).

Results: Baseline score of IBDQ was 4,6, range (2,31-6,84), with an impairment of the five dimensions of HRQoL compared with inactive patients. Results obtained in 8 dimensions of SF-36 showed worse HRQoL than Spanish general population. At 6 months patients had a significant improvement in overall IBDQ score -5,8 (1,58 -6,97)- and also in all IBDQ dimensions. All the 8 dimensions of SF-36 obtained a significant improvement. At twelve months score of IBDQ was 6,1, range (2,7-6,98), with improvement in all dimensions compared with baseline and 6 months. SF-36 showed a similar significant improvement in all subscales.

Conclusions: Thiopurine immunomodulators alone or with other treatments have a positive and long lasting impact on HRQoL of IBD patients.

Figure 1

SF-36 mean scale scores of Crohn's disease and ulcerative colitis patients in comparison to Spanish general population reference values. PF: Physical Functioning, RP: Role physical, BP: Bodily Pain, GH: General health, VT: Vitality, SF: Social functioning, RE: Role emotional, MH: Mental health.