P152 Impact of disease location on burden of illness in patients with moderate-severe Crohn’s disease: A real-world survey in the United States, France, Germany, Italy, Spain, and United Kingdom (5EU)

Sikirica, M.(1);Lynch, J.(2);Kershaw, J.(3);Lukanova, R.(3);Baker, S.(3);Milligan, G.(3);

(1)Janssen Global Services- LLC, Global Commercial Strategy, Horsham, United States;(2)Janssen Research & Development- LLC, Immunology, Horsham, United States;(3)Adelphi Real World, Autoimmune, Bollington, United Kingdom;


Presentation and risks of progression and complications differ according to Crohn’s disease (CD) location. The objective of this study was to investigate how disease burden differs based on CD location, from physician and patient perspective.


Data drawn from the Adelphi Inflammatory Bowel Disease (IBD) Disease Specific Programme™, a point-in-time survey of gastroenterologists (GEs) and their IBD patients from two waves (Nov 2014-Mar 2015; Sep 2017-Jan 2018) in the United States, and 5EU. GEs completed physician-reported questionnaires for 5-10 consecutively consulting patients with CD, covering demographics, treatment, symptoms, and CD location. Same patients completed voluntary patient-reported questionnaire including outcome measures such as Short IBD Questionnaire (SIBDQ), EuroQol 5-dimension questionnaire (EQ-5D), and Work Productivity and Activity Impairment questionnaire.

Comparisons were drawn between patients with CD in 3 locations: ileal only (IL), ileocolonic (IC), and colonic only (CO). Outcomes such as patient-reported level of pain, sleep disturbance, and fatigue, were compared between locations using linear regression analyses that included potential confounding variables age, gender, body mass index, comorbidities (using Charlson Comorbidity Index [CCI]) and severity at diagnosis. Least square (LS) means were generated for each location and compared using a p-value generated from Wald tests. Variables such as current treatment and symptoms, were compared using univariate tests (ANOVA, chi2 test). Base sizes varied due to the voluntary nature of patient participation.


686 GEs collected data on 2354 patients with moderate-severe CD, identifying patients with IL (28.3%), IC (45.7%), and CO (26.0%) location. Overall demographic characteristics were similar, mean age 39 years, proportion of male patients 51.4%, mean Body Mass Index 24.0, mean CCI 0.14.

Differences were observed between the 3 groups (Table 1). Patients with ileal involvement (IL and IC) were prescribed biologics more often and had greater symptom burden than CO patients, except for rectal urgency. IL patients tended to have slightly greater burden overall in terms of symptomatology and severity. There was similarity across SIBDQ and EQ-5D scores; however, absenteeism was higher amongst IL and IC patients, compared with CO patients.


Differences were observed between IL, IC, and CO CD location groups. Despite IC patients experiencing the greatest burden overall, there were key distinctions between IL and CO patients, particularly in medication, symptoms, and work productivity impairment, suggesting that disease management with attention to CD location could lead to better patient outcomes.