Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases
Introduction Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine wi...
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| Veröffentlicht in: | Digestive diseases and sciences 2017-01, Vol.62 (1), p.197-206 |
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| creator | Stevens, Betsy W. Borren, Nynke Z. Velonias, Gabriella Conway, Grace Cleland, Thom Andrews, Elizabeth Khalili, Hamed Garber, John G. Xavier, Ramnik J. Yajnik, Vijay Ananthakrishnan, Ashwin N. |
| description | Introduction
Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents.
Methods
This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality.
Results
Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8,
p
= 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5,
p
= 0.009). Parallel reductions in depression and anxiety were also noted (
p
|
| doi_str_mv | 10.1007/s10620-016-4356-2 |
| format | Article |
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Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents.
Methods
This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality.
Results
Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8,
p
= 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5,
p
= 0.009). Parallel reductions in depression and anxiety were also noted (
p
< 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6.
Conclusions
Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-016-4356-2</identifier><identifier>PMID: 27796768</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adalimumab ; Adalimumab - therapeutic use ; Adult ; Affect ; Analysis ; Antibodies, Monoclonal - therapeutic use ; Antibodies, Monoclonal, Humanized - therapeutic use ; Antirheumatic Agents - therapeutic use ; Anxiety - psychology ; Biochemistry ; Care and treatment ; Certolizumab Pegol - therapeutic use ; Cohort Studies ; Colitis, Ulcerative - drug therapy ; Colitis, Ulcerative - psychology ; Crohn Disease - drug therapy ; Crohn Disease - psychology ; Depression - psychology ; Depression, Mental ; Female ; Gastroenterology ; Gastrointestinal Agents - therapeutic use ; Health aspects ; Hepatology ; Humans ; Inflammatory bowel diseases ; Inflammatory Bowel Diseases - drug therapy ; Inflammatory Bowel Diseases - psychology ; Infliximab - therapeutic use ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Oncology ; Original Article ; Prospective Studies ; Sleep ; Surveys and Questionnaires ; Transplant Surgery ; Treatment Outcome ; Tumor necrosis factor ; Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><ispartof>Digestive diseases and sciences, 2017-01, Vol.62 (1), p.197-206</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>COPYRIGHT 2017 Springer</rights><rights>Digestive Diseases and Sciences is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c570t-d0620e30dd39571bddc91a094b8101a6959514ea61a2a60ab8e37b463641cbdc3</citedby><cites>FETCH-LOGICAL-c570t-d0620e30dd39571bddc91a094b8101a6959514ea61a2a60ab8e37b463641cbdc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-016-4356-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-016-4356-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27796768$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stevens, Betsy W.</creatorcontrib><creatorcontrib>Borren, Nynke Z.</creatorcontrib><creatorcontrib>Velonias, Gabriella</creatorcontrib><creatorcontrib>Conway, Grace</creatorcontrib><creatorcontrib>Cleland, Thom</creatorcontrib><creatorcontrib>Andrews, Elizabeth</creatorcontrib><creatorcontrib>Khalili, Hamed</creatorcontrib><creatorcontrib>Garber, John G.</creatorcontrib><creatorcontrib>Xavier, Ramnik J.</creatorcontrib><creatorcontrib>Yajnik, Vijay</creatorcontrib><creatorcontrib>Ananthakrishnan, Ashwin N.</creatorcontrib><title>Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Introduction
Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents.
Methods
This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality.
Results
Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8,
p
= 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5,
p
= 0.009). Parallel reductions in depression and anxiety were also noted (
p
< 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6.
Conclusions
Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD.</description><subject>Adalimumab</subject><subject>Adalimumab - therapeutic use</subject><subject>Adult</subject><subject>Affect</subject><subject>Analysis</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Anxiety - psychology</subject><subject>Biochemistry</subject><subject>Care and treatment</subject><subject>Certolizumab Pegol - therapeutic use</subject><subject>Cohort Studies</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>Colitis, Ulcerative - psychology</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn Disease - psychology</subject><subject>Depression - psychology</subject><subject>Depression, Mental</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal Agents - therapeutic use</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Inflammatory bowel diseases</subject><subject>Inflammatory Bowel Diseases - drug therapy</subject><subject>Inflammatory Bowel Diseases - psychology</subject><subject>Infliximab - therapeutic use</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prospective Studies</subject><subject>Sleep</subject><subject>Surveys and Questionnaires</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor necrosis factor</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkk9v1DAQxSMEokvhA3BBlrhwSfE4iR1fkJbyb6UihChcLSee7LpK7GAnrZZPj6MtpUUg5IMtv988jccvy54CPQFKxcsIlDOaU-B5WVQ8Z_eyFVSiyFnF6_vZKgnpDMCPskcxXlBKpQD-MDtiQkgueL3K3Dc0vrc_5kE35HyHQY97solkHaNvrZ7QkCs77Yh2ZDOMwV_igG4i1pEvPeJIPs-6t9M-6YZ89N4sysZ1vR4GPfmwJ6_9FfbkjY2oI8bH2YNO9xGfXO_H2dd3b89PP-Rnn95vTtdneVsJOuVmeRcW1JhCVgIaY1oJmsqyqYGC5rKSFZSoOWimOdVNjYVoSl7wEtrGtMVx9urgO87NgKZNPQfdqzHYQYe98tqqu4qzO7X1l6piUEvBk8GLa4Pgv88YJzXY2GLfa4d-jgpkyRgISav_o3VRSlmLmiX0-R_ohZ-DS5NIVJU-TQCI39RW96is63xqsV1M1VoAk4UEDok6-QuVlsHBtt5hZ9P9nQI4FLTBxxiwuxkHULXkSR3ypFJs1JIntTT87PYcbyp-BSgB7ADEJLkthlsv-qfrT0SL1F8</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Stevens, Betsy W.</creator><creator>Borren, Nynke Z.</creator><creator>Velonias, Gabriella</creator><creator>Conway, Grace</creator><creator>Cleland, Thom</creator><creator>Andrews, Elizabeth</creator><creator>Khalili, Hamed</creator><creator>Garber, John G.</creator><creator>Xavier, Ramnik J.</creator><creator>Yajnik, Vijay</creator><creator>Ananthakrishnan, Ashwin N.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20170101</creationdate><title>Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases</title><author>Stevens, Betsy W. ; Borren, Nynke Z. ; Velonias, Gabriella ; Conway, Grace ; Cleland, Thom ; Andrews, Elizabeth ; Khalili, Hamed ; Garber, John G. ; Xavier, Ramnik J. ; Yajnik, Vijay ; Ananthakrishnan, Ashwin N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c570t-d0620e30dd39571bddc91a094b8101a6959514ea61a2a60ab8e37b463641cbdc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adalimumab</topic><topic>Adalimumab - therapeutic use</topic><topic>Adult</topic><topic>Affect</topic><topic>Analysis</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Anxiety - psychology</topic><topic>Biochemistry</topic><topic>Care and treatment</topic><topic>Certolizumab Pegol - therapeutic use</topic><topic>Cohort Studies</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>Colitis, Ulcerative - psychology</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn Disease - psychology</topic><topic>Depression - psychology</topic><topic>Depression, Mental</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastrointestinal Agents - therapeutic use</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Inflammatory bowel diseases</topic><topic>Inflammatory Bowel Diseases - drug therapy</topic><topic>Inflammatory Bowel Diseases - psychology</topic><topic>Infliximab - therapeutic use</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Prospective Studies</topic><topic>Sleep</topic><topic>Surveys and Questionnaires</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><topic>Tumor necrosis factor</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stevens, Betsy W.</creatorcontrib><creatorcontrib>Borren, Nynke Z.</creatorcontrib><creatorcontrib>Velonias, Gabriella</creatorcontrib><creatorcontrib>Conway, Grace</creatorcontrib><creatorcontrib>Cleland, Thom</creatorcontrib><creatorcontrib>Andrews, Elizabeth</creatorcontrib><creatorcontrib>Khalili, Hamed</creatorcontrib><creatorcontrib>Garber, John G.</creatorcontrib><creatorcontrib>Xavier, Ramnik J.</creatorcontrib><creatorcontrib>Yajnik, Vijay</creatorcontrib><creatorcontrib>Ananthakrishnan, Ashwin N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stevens, Betsy W.</au><au>Borren, Nynke Z.</au><au>Velonias, Gabriella</au><au>Conway, Grace</au><au>Cleland, Thom</au><au>Andrews, Elizabeth</au><au>Khalili, Hamed</au><au>Garber, John G.</au><au>Xavier, Ramnik J.</au><au>Yajnik, Vijay</au><au>Ananthakrishnan, Ashwin N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>62</volume><issue>1</issue><spage>197</spage><epage>206</epage><pages>197-206</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>Introduction
Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents.
Methods
This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality.
Results
Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8,
p
= 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5,
p
= 0.009). Parallel reductions in depression and anxiety were also noted (
p
< 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6.
Conclusions
Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27796768</pmid><doi>10.1007/s10620-016-4356-2</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Digestive diseases and sciences, 2017-01, Vol.62 (1), p.197-206 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5218976 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adalimumab Adalimumab - therapeutic use Adult Affect Analysis Antibodies, Monoclonal - therapeutic use Antibodies, Monoclonal, Humanized - therapeutic use Antirheumatic Agents - therapeutic use Anxiety - psychology Biochemistry Care and treatment Certolizumab Pegol - therapeutic use Cohort Studies Colitis, Ulcerative - drug therapy Colitis, Ulcerative - psychology Crohn Disease - drug therapy Crohn Disease - psychology Depression - psychology Depression, Mental Female Gastroenterology Gastrointestinal Agents - therapeutic use Health aspects Hepatology Humans Inflammatory bowel diseases Inflammatory Bowel Diseases - drug therapy Inflammatory Bowel Diseases - psychology Infliximab - therapeutic use Male Medical research Medicine Medicine & Public Health Medicine, Experimental Oncology Original Article Prospective Studies Sleep Surveys and Questionnaires Transplant Surgery Treatment Outcome Tumor necrosis factor Tumor Necrosis Factor-alpha - antagonists & inhibitors |
| title | Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases |
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