The following is a summary of “Exploring the Relationship Between Patient Symptoms and Provider Goals for Mucosal Healing in IBD: Insights from the IBD Qorus Survey Data,” published in the January 2024 issue of Gastroenterology by Crohn’s & Colitis Congress 2024.
Beyond symptom relief, STRIDE-II guidelines advocate for a coordinated physician-patient approach in inflammatory bowel disease (IBD), targeting both short-term symptom improvement and long-term endoscopic remission.
Researchers conducted a retrospective study to explore the link between BD QORUS data, patient-reported outcomes, and physician efforts toward achieving mucosal healing (MH) in IBD patients.
They utilized survey data matched between patients and providers from the Crohn’s & Colitis Foundation IBD QORUS program. The analysis focused on surveys completed (June 2021 to October 2022). Univariate and multivariate analyses established the link between the severity of patient-reported symptoms and the frequency of mucosal healing (MH) assessment, utilizing modalities like endoscopy and fecal calprotectin. Examined the impact of symptoms and MH status on treatment.
The results showed that 5,460 paired patient and provider surveys (Crohn’s disease (CD), n=3,276; ulcerative colitis (UC), n=2,184) underwent analysis. Demographic details, including age, sex, and steroid-free MH, along with the severity of patient-reported symptoms, exhibited similarity between CD and UC patients. CD and UC patients indicated that abdominal pain severity influenced plans for future endoscopy (CD, P=0.000019; UC, P=0.000055) but not for fecal calprotectin testing. Stool frequency reports in both IBD populations significantly impacted plans for future endoscopy (CD, P=0.000001; UC, P=0.000001) and fecal calprotectin testing (CD, P=0.000304; UC, P=0.000001). Blood in stool did not affect MH assessment in CD patients but significantly influenced plans for endoscopy (P=0.000001) and fecal calprotectin testing (P=0.000001) in UC patients. MH discussions occurred with 82.4% of CD patients and 85.3% of UC patients. Treatment plans for those lacking steroid-free MH were influenced by symptom severity (P=0.000001).
They concluded that patient symptoms guided IBD treatment choices and could enhance outcomes, even without achieving steroid-free mucosal healing.
