OBJECTIVES: Crohn’s disease (CD) substantially impacts HRQoL, with complications such as perianal fistulas potentially increasing burden of illness. We investigated HRQoL in patients with CD and CPF and those without CPF, and for patients with CPF with and without CPF-related surgery.

METHODS: Data were collected via cross-sectional, web-enabled questionnaires for three US patient cohorts aged 18–89 years with self-reported physician-diagnosed CD: (1) without CPF, with CPF (2) without CPF-related surgery and (3) with CPF-related surgery. HRQoL assessment used the EQ-5D-5L questionnaire (comprising a five-dimension profile: mobility, self-care, usual activities, pain/discomfort, anxiety/depression; and the visual analogue scale [EQ-VAS; scored 0–100, higher values reflecting increased HRQoL]). Health state index scores were calculated using the US value set (scores range from <0–1), with greater scores indicating higher health utility. Data were summarized using descriptive statistics (significance reported at 0.05).

RESULTS: Overall, 403 patients were analyzed (cohort 1, n=300 [mean (standard deviation) age, 47 (16.4) years]; cohort 2, n=51 [40 (12.2) years]; cohort 3, n=52 [39 (13.1) years]). Patients with CPF reported lower mean overall index scores than those without (0.69 [cohort 1] versus 0.57 [cohort 2] and 0.55 [cohort 3]; both p<0.01), and lower scores across all five EQ-5D-5L dimensions, especially anxiety/depression (p≤0.01). Mean EQ-VAS scores did not significantly differ, although cohort 3 scored lower (59.5) than cohorts 1 (64.6) and 2 (63.1). Mean cohort utility scores were lower than for the overall US population (0.85) and other diseases (0.79 [diabetes]; 0.71 [depression]).

CONCLUSIONS: Real-world patients with CD and CPF report worse utility and EQ-VAS scores than those without CPF, the US general population or for other diseases. These data demonstrate that CPF-related surgery did not increase HRQoL, highlighting a need for improved disease management, and may aid future economic model development.

Study sponsor: Takeda Pharmaceuticals USA, Inc.