Hospitalization, surgery, work loss, and impaired quality of life contribute to the cost and burden of care for patients with Crohn's disease.
In this study, physicians from the United States examined the impact of remission on patients' employment, quality of life, and hospitalization and surgery.
Clinical remission was defined using the Crohn's disease activity index (CDAI).
The efficacy and safety of long-term dosing of infliximab was compared to a single dose in 573 patients with moderately-to-severely active Crohn's disease.
|At baseline, patients had a 38% unemployment rate.|
|American Journal of Gastroenterology|
The team compared employment status at week 54, between patients in CDAI remission and those who were not, for patients who were not employed at baseline.
They also compared physical component summary (PCS) and mental component summary (MCS) scores of the SF-36 questionnaire.
In addition, the physicians assessed Crohn's-related hospitalization and surgery in 4 groups of patients who spent 0 to 25%, 25 to 50%, 50 to 75%, or 75 to 100% of the study period in remission.
At baseline, the team found that patients had a severely impaired quality of life and a 38% unemployment rate.
In patients who were unemployed at baseline, 31% of those patients who achieved CDAI remission at week 54 were employed, compared to 16% who were not.
The PCS and MCS scores of patients in CDAI remission at week 54 were significantly higher. These scores indicated better mental and physical functioning, than those patients not in remission.
Furthermore, hospitalization and surgery rates decreased as the percentage of time patients were in CDAI remission increased.
Dr Gary Lichtenstein's team concluded, "CDAI remission is associated with reduced hospitalizations and surgeries, increased employment, and normalized quality of life".
"Sustained CDAI remission should be the key therapeutic goal in managing Crohn's disease".