Effect of adalimumab on clinical outcomes and health-related quality of life among patients with ulcerative colitis in a clinical practice setting: Results from inspirADA

<h4>Background and Aims</h4> <p>Randomised trials have described the benefits of adalimumab [ADA] for ulcerative colitis [UC]; however, few data are available on health-related quality of life [HRQL] and health care costs in clinical practice.</p> <h4>Methods</h4>...

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Bibliographic Details
Main Authors: Travis, S, Feagan, BG, Peyrin-Biroulet, L, Panaccione, R, Danese, S, Lazar, A, Robinson, AM, Petersson, J, Pappalardo, BL, Bereswill, M, Chen, N, Wang, S, Skup, M, Thakkar, RB, Chao, J
Format: Journal article
Published: Oxford University Press 2017
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Summary:<h4>Background and Aims</h4> <p>Randomised trials have described the benefits of adalimumab [ADA] for ulcerative colitis [UC]; however, few data are available on health-related quality of life [HRQL] and health care costs in clinical practice.</p> <h4>Methods</h4> <p>InspirADA, a multicentre, prospective study, evaluated the effect of ADA in patients with moderate to severe UC treated according to usual clinical practice. Outcomes assessed were: Simple Clinical Colitis Activity Index [SCCAI] response/remission rates; changes in HRQL; all-cause direct costs; and UC-related direct and indirect costs from baseline to Week 26.</p> <h4>Results</h4> <p>Data from 463 patients were analysed. At Week 26, 67% (95% confidence interval [CI]: 62%, 71%) of patients achieved response; 48% [95% CI: 44%, 53%] were in remission. For the overall population, significant [all p &lt; 0.001] improvements from baseline to Week 26 were observed for the Short Inflammatory Bowel Disease Questionnaire [SIBDQ] (mean change ± standard deviation [SD]: 17.4 ± 14.5) and the European Quality of Life—5 Dimensions—5 Level [EQ-5D-5L] (index: 0.1 ± 0.2; visual analogue scale [VAS]: 19.5 ± 25.8). Parallel improvements were seen in work productivity [11% absolute decrease in absenteeism; 25% absolute decrease in impairment while working; and 27% absolute decrease in impairment of ability to perform daily activities, all p &lt; 0.001]. Among study completers, cumulative all-cause medical costs and UC-related medical costs were significantly [both p &lt; 0.001] reduced by 59% and 77%, respectively, 6 months after initiation of therapy compared with the preceding 6 months. The safety profile of ADA was consistent with that observed in previous clinical trials.</p> <h4>Conclusions</h4> <p>ADA therapy in usual clinical practice is effective at improving and maintaining symptomatic control, improving HRQL, and decreasing costs of medical care among patients with UC.</p>