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Remission on thiopurinic immunomodulators normalizes quality of life and psychological status in patients with Crohn's disease

Authors

  • Xavier Calvet,

    Corresponding author
    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
    • Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autónoma de Barcelona, Parc Taulí, s/n, 08208 Sabadell, Barcelona, Spain
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  • Olga Gallardo,

    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
    2. Servei de Psiquiatria, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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  • Ramón Coronas,

    1. Servei de Psiquiatria, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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  • Francesc Casellas,

    1. Unitat d'Atenció Crohn-Colitis, Servei de Digestiu, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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  • Antònia Montserrat,

    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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  • Antonio Torrejón,

    1. Unitat d'Atenció Crohn-Colitis, Servei de Digestiu, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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  • Mercedes Vergara,

    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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  • Rafel Campo,

    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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  • Enric Brullet

    1. Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain
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Abstract

Background: Thiopurinic immunomodulators are effective for maintaining symptom remission in Crohn's disease. Little is known, however, about their effect on patients' quality of life or psychological well-being. The present study aimed to determine whether remission induced by thiopurinic immunomodulators returns levels of quality of life and psychological well-being to normal. Materials and Methods: A case-control study was performed. Cases were 33 patients with Crohn's disease treated with azathioprine or 6-mercaptopurine and in stable remission for at least 6 months. Sixty-six healthy individuals matched 2:1 by age and sex and 14 patients with active Crohn's disease were included as control groups. Quality of life was evaluated with the Short Form (SF-36) questionnaire, and the respective Hamilton rating scales were used for anxiety and depression. ANOVA with Bonferroni's correction was used for multiple comparisons. Results: SF-36 global scores were 85 in the study group, 85 in healthy controls (P = 1), and 58.6 in patients with active disease (P < 0.001 for the comparison with the other 2 groups). The differences between values were 0 (95% CI −4-4), 26.4 (95% CI 20–32), and 26.4 (95% CI 19–33), respectively. The respective anxiety and depression scores were 6.5, 5.5, and 16.2 and 3.7, 3.3, and 10.9. No significant differences were observed in any of the SF-36 domains between case and control groups, whereas in patients with active disease, all domains were significantly worse. Conclusions: Thiopurinic immunomodulator-induced remission restores normal levels of quality of life and psychological well-being in Crohn's disease patients.

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