Impact of Biological Therapies and Tofacitinib on Real-world Work Impairment in Inflammatory Bowel Disease Patients: A Prospective Study

Inflamm Bowel Dis. 2022 Feb 4;izac002. doi: 10.1093/ibd/izac002. Online ahead of print.

Pepijn W A Thomas 1, Nathan den Broeder 1, Monique Derikx 2, Wietske Kievit 3, Rachel L West 4, Maurice G V M Russel 5, Jeroen M Jansen 6, Tessa E H Römkens 7, Frank Hoentjen 8


Author information

  • 1Department of Gastroenterology and Hepatology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
  • 2Occupational Medicine, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
  • 3Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, The Netherlands.
  • 4Department of Gastroenterology and Hepatology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands.
  • 5Department of Gastroenterology and Hepatology, Medical Spectrum Twente, Enschede, The Netherlands.
  • 6Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
  • 7Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
  • 8Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada.


Background: There are limited real-world data on the change in total work impairment (TWI) in biological-treated patients with inflammatory bowel disease (IBD). This study aimed to evaluate the real-world effects of initiating biological therapy or tofacitinib on change in TWI in IBD patients.

Methods: This multicenter prospective cohort study enrolled IBD patients who started treatment with biological therapy or tofacitinib. Subjects completed the work productivity and activity impairment (WPAI) questionnaire and short inflammatory bowel disease questionnaire at therapy initiation and at week 26. Total work impairment comprises working hours missed due to sick leave and impact of disease during working hours (range 0%-100%). Clinical disease activity was assessed using the Harvey-Bradshaw Index and Simple Clinical Colitis Activity Index (SCCAI).

Results: We included 137 IBD patients for analyses (median age 38 years, 58% Crohn's disease [CD]). The median baseline TWI was 50% and decreased by a median of 10%-points of points after 26 weeks. Patients with continued biological therapy or tofacitinib use, clinical disease activity at baseline, and clinical response or remission at week 26 showed a greater median TWI reduction (22%-points) than the remaining study patients (7%-points; P = .014). Ulcerative colitis (UC) and IBD-unclassified (IBD-U) patients showed a greater median TWI reduction (26%-points) than CD patients (6%-points); P = .041. Correlations were observed between decrease in TWI and decrease in SCCAI, decrease in fatigue and increase in quality of life.

Conclusions: Work impairment in IBD patients decreased following biological therapy or tofacitinib initiation. Patients achieving clinical remission or response showed the greatest improvement, especially UC and IBD-U patients.


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