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Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

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Abstract

Background

Clinical activity and quality of life (QOL) indices assess disease activity in Crohn’s disease (CD) and ulcerative colitis (UC). However, a paucity of data exists on the validity of these indices according to disease characteristics.

Aims

To examine the correlation between QOL and clinical activity indices and endoscopic disease activity according to disease characteristics.

Methods

We used a prospective registry to identify CD and UC patients ≥18 years old with available information on Short Inflammatory Bowel Disease Questionnaire scores (SIBDQ), Harvey–Bradshaw Index (HBI) and simple endoscopic scores for CD (SES-CD), and Simple Clinical Colitis Activity Index (SCCAI) and Mayo endoscopic score for UC. We used Spearman rank correlations to calculate correlations between indices and Fisher transformation to compare correlations across disease characteristics.

Results

Among 282 CD patients, we observed poor correlation between clinical activity and QOL indices to SES-CD with no differences in correlation according to disease characteristics. Conversely, among 226 UC patients, clinical activity and QOL had good correlation to Mayo endoscopic score (r = 0.55 and −0.56, respectively) with better correlations observed with left-sided versus extensive colitis (r = 0.73 vs. 0.45, p = 0.005) and shorter duration of disease (r = 0.61 vs. 0.37, p = 0.04).

Conclusions

Our data suggest good correlation between SCCAI and endoscopic disease activity in UC, particularly in left-sided disease. Poor correlations between HBI or SIBDQ and SES-CD appear to be consistent across different disease phenotypes.

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Acknowledgments

ST was involved in the study concept and design, analysis and interpretation of the data, drafting of the manuscript, and critical revision of the manuscript. KOS was involved in the statistical analysis and drafting of the manuscript. DKL and PS were involved in acquisition of data. DSP was involved in the study concept and design and critical revision of the manuscript for important intellectual content. HCS, DN, VY, ANN were involved acquisition of data and critical revision of the manuscript for important intellectual content. HK was involved in the study concept and design, analysis and interpretation of the data, and critical revision of the manuscript.

Funding

This work is supported by a career development award from the American Gastroenterological Association (AGA) and the National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK099681 to HK) along with a grant from the National Institutes of Health (K23 DK097142 to ANN).

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    Authors and Affiliations

    1. Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, 85724, USA

      Sasha Taleban

    2. Department of Medicine, University of Arizona Center of Aging, Tucson, AZ, 85724, USA

      Sasha Taleban

    3. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

      Kathleen O. Stewart, Holly C. Sturgeon, Vijay Yajnik, Ramnik J. Xavier, Ashwin N. Ananthakrishnan & Hamed Khalili

    4. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

      Darrick K. Li & Prashant Singh

    5. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

      Darrell S. Pardi

    6. The Broad Institute, Cambridge, MA, 02124, USA

      Ramnik J. Xavier

    7. Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, 02114, USA

      Ramnik J. Xavier

    8. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

      Ashwin N. Ananthakrishnan & Hamed Khalili

    9. Crohn’s and Colitis Center, Massachusetts General Hospital, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA

      Hamed Khalili

    10. Section of Gastroenterology, Banner University Medical Center, 1501 N. Campbell Ave, Tucson, AZ, 85724, USA

      Sasha Taleban

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    Correspondence to Sasha Taleban or Hamed Khalili.

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    Conflict of interest

    Dr. Ananthakrishnan is a member of the scientific advisory board for Exact Sciences, AbbVie, and Cubist pharmaceuticals. Dr. Khalili has received consultant fee from AbbVie. Dr. Yajnik has received consulting fees from NPS, Janssen Pharmaceuticals, and UCB. None of the authors had any personal disclosures.

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    Sasha Taleban and Kathleen O. Stewart have contributed equally to the manuscript.

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    Taleban, S., Stewart, K.O., Li, D.K. et al. Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes. Dig Dis Sci 61, 2627–2635 (2016). https://doi.org/10.1007/s10620-016-4180-8

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