Effects of anti-TNF therapy and immunomodulators on anxiety and depressive symptoms in patients with inflammatory bowel disease: a 5-year analysis.

Siebenhüner, Alexander R; Rossel, Jean-Benoît; Schreiner, Philipp; Butter, Matthias; Greuter, Thomas; Krupka, Niklas; Jordi, Sebastian B. U.; Biedermann, Luc; Rogler, Gerhard; Misselwitz, Benjamin; von Känel, Roland (2021). Effects of anti-TNF therapy and immunomodulators on anxiety and depressive symptoms in patients with inflammatory bowel disease: a 5-year analysis. Therapeutic advances in gastroenterology, 14, p. 17562848211033763. Sage 10.1177/17562848211033763

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Background and aims

Anxiety and depression are prevalent in patients with inflammatory bowel diseases (IBD), especially during IBD flares. IBD therapies can profoundly affect the mood of patients with IBD. We aimed to determine the long-term impact of anti-tumor necrosis factor (anti-TNF) and immunomodulators (IM) on anxiety and depressive symptoms in IBD patients.

Methods

We compared three treatment groups with IM only (group A), anti-TNF ± IM (group B) and no such therapy (group C). Patients completed the hospital anxiety and depression scale (HADS) at 1 year, 3 years, and 5 years after start of treatment.

Results

In total, 581 patients with IBD (42.9% Crohn's disease, 57.1% ulcerative colitis/IBD unclassified) participated in this study. Effects of treatment were analyzed in a mixed effects model, with and without correction for confounders. Compared with group C, group B showed a significant treatment-related improvement in both anxiety and depressive symptoms within the first 2.5 years and also thereafter. Group A showed a significant long-term improvement of anxiety and both short-term and long-term improvement in depressive symptoms. The significance of these results was maintained after correction for confounders, including corticosteroid treatment. Additionally, both groups A and B showed a significant decrease in disease activity in the first 2.5 years after start of treatment and also thereafter. Anti-TNF and IM treatment were associated with a similarly significant decrease in anxiety and depressive symptoms over an observation period of up to 5 years.

Conclusion

Besides a clear benefit for disease activity, anti-TNF and IM apparently improve the mood of patients with IBD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Krupka, Niklas; Jordi, Sebastian Bruno Ulrich and Misselwitz, Benjamin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1756-283X

Publisher:

Sage

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

08 Nov 2021 16:45

Last Modified:

14 Nov 2021 01:46

Publisher DOI:

10.1177/17562848211033763

PubMed ID:

34484421

Uncontrolled Keywords:

anti-TNF anxiety depressive symptoms hospital anxiety and depression scale immune-modulatory therapy inflammatory bowel disease mood psychosocial factors

BORIS DOI:

10.48350/160495

URI:

https://boris.unibe.ch/id/eprint/160495

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