Borren, N.Z. (Nynke) (2016) Impact of Vedolizumab and anti-TNF biologics on Sleep Qualityand Mood in Inflammatory Bowel Diseases: A Prospective Study. thesis, Medicine.
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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 included160 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 therapy was associated with improvement in sleep and mood quality in IBD.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor (NL): and Weersma, Prof. Dr. Rinse K. and Professor in Gastroenterology and Hepatology and GIPS-M supervisor (NL): and Welling, Dr. Gjalt W. and Department of Medical Microbiology and University Medical Center Groningen |
| Supervisor name: | Ananthakrishnan, Ashwin N. MD and Assistant Professor of Medicine and Crohn’s and Colitis Center, Division of Gastroenterology and Massachusetts General Hospital – Harvard Medical School |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2149 |
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