Faculty Bibliography

OBJECTIVE:The aim of this study was to determine whether the effects of prolonged therapy (≥1 year) with anti-tumor necrosis factor (TNF) agents were sustained on the health-related quality of life (HRQoL) in patients with inflammatory bowel disease (IBD). METHODS:A cross-sectional survey of patients with IBD who were treated with anti-TNF agents was performed. Results of the validated HRQoL measures (inflammatory bowel disease questionnaire [IBDQ], EuroQoL-5 dimensions [EQ-5D], health status visual analogue scale [VAS] and the Zung self-rating depression scale) were recorded and compared between patients treated with anti-TNF agents for <1 year and ≥1 year. RESULTS:A total of 41 patients were finally enrolled in the study. Among them, 11 (26.8%) had received anti-TNF therapy for less than one year with a median duration of 7 months (range 3-11 months), while the other 30 (73.2%) had been treated for ≥1 year with a median duration of 42 months (range 12-104 months). Crohn's disease was the most common type in both groups. None of the mean IBDQ, EQ-5D and EQ-5D plus VAS, or Zung self-rating depression scale scores differed significantly between the two groups of patients. CONCLUSIONS:Improvements in HRQoL for IBD patients on anti-TNF therapy were sustained for longer than one year. HRQoL measures for IBD patients treated with anti-TNF therapy for <1 year do not differ significantly from those treated for ≥1 year, but a trend towards improved HRQoL measures with prolonged therapy can be obtained.

Irritable bowel syndrome (IBS) is a complex clinical process with multiple pathophysiologic mechanisms. There has recently been a shift in the treatment of patients with severe IBS symptoms to disease-modifying therapies as opposed to symptomatic treatment. Because pathophysiologic differences exist between men and women, so does the efficacy of treatment options. These differences could further explain gender-related differences in disease prevalence and treatment response. A brief discussion of the definition, epidemiology, and diagnostic criteria of IBS is followed by a comprehensive review of the current treatment choices and potential future therapeutic options of IBS in women.