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The inter-relationship of symptom severity and quality of life in 2055 patients with primary biliary cholangitis.

Dyson, JK; Wilkinson, N; Jopson, L; Mells, G; Bathgate, A; Heneghan, MA; Neuberger, J; ... Jones, DEJ; + view all (2016) The inter-relationship of symptom severity and quality of life in 2055 patients with primary biliary cholangitis. Alimentary Pharmacology and Therapeutics , 44 (10) pp. 1039-1050. 10.1111/apt.13794. Green open access

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Abstract

Background Age at presentation with primary biliary cholangitis (PBC) is associated with differential response to ursodeoxycholic acid (UDCA) therapy. Younger‐presenting patients are less likely to respond to treatment and more likely to need transplant or die from the disease. PBC has a complex impact on quality of life (QoL), with systemic symptoms often having significant impact. Aim To explain the impact of age at presentation on perceived QoL and the inter‐related symptoms which impact upon it. Methods Using the UK‐PBC cohort, symptoms were assessed using the PBC‐40 and other validated tools. Data were available on 2055 patients. Results Of the 1990 patients reporting a global PBC‐QoL score, 66% reported good/neutral scores and 34% reported poor scores. Each 10‐year increase in age at presentation was associated with a 14% decrease in risk of poor perceived QoL (OR = 0.86, 95% CI: 0.75–0.98, P < 0.05). All symptom domains were similarly age‐associated (P < 0.01). Social dysfunction was the symptom factor with the greatest impact on QoL. Median (interquartile range) PBC‐40 social scores for patients with good perceived QoL were 18 (14–23) compared with 34 (29–39) for those with poor QoL. Conclusion The majority of patients with primary biliary cholangitis do not feel their QoL is impaired, although impairment is reported by a sizeable minority. Age at presentation is associated with impact on perceived QoL and the symptoms impairing it, with younger patients being more affected. Social dysfunction makes the greatest contribution to QoL impairment, and it should be targeted in trials aimed at improving life quality

Type: Article
Title: The inter-relationship of symptom severity and quality of life in 2055 patients with primary biliary cholangitis.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/apt.13794
Publisher version: https://doi.org/10.1111/apt.13794
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10082184
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