Ulcerative Colitis Severity, QOL Affect Work Productivity, Nonwork Activities

Using the Mayo and IBDQ scores can provide insights into work productivity and activity impairment in patients with UC.

Severity of disease activity and quality of life (QOL) are strongly associated with work-related productivity and activity impairments among patients with moderate to severe ulcerative colitis (UC), according to study findings published in the Journal of Crohn’s and Colitis.

Using available data from 3 phase 3 tofacitinib studies, OCTAVE Induction 1 and 2 and OCTAVE Sustain (ClinicalTrials.gov Identifier: NCT01465763; NCT01458951; NCT01458574, respectively), researchers examined the relationships between disease severity scores and work productivity and activity impairment measures among patients with UC.

Patients with moderate to severe UC from the 3 studies received between 5 to 15 mg of tofacitinib twice daily or placebo, depending on the random group assignment and which study. During the maintenance study, tofacitinib dose ranged from 5 to 10 mg, whereas during the 2 induction studies, the dose was higher, ranging from 10 to 15 mg. 

Researchers determined disease activity using the Mayo score based on stool frequency, rectal bleeding, endoscopic disease activity markers, and the Physician’s Global Assessment. Patient health-related quality of life (HRQoL) related to UC was also measured using the Inflammatory Bowel Disease Questionnaire (IBDQ), and the effect of UC on work was measured using the Work Productivity and Activity Impairment-UC (WPAI-UC).

Disease activity via the Mayo/IBDQ scores was strongly associated with the WPAI-UC scores, reflecting work productivity loss, presenteeism, and activity impairment, while weaker associations with absenteeism were revealed. This finding indicated that patients with moderate to severe UC attend work regardless of the severity of disease activity or poor QOL related to their UC.

Researchers observed that for every 3 points by which the total Mayo score improved, the scores on the WPAI-UC also improved on average by 14.7 points for presenteeism, 13.6 points for work productivity loss, and 16.4 points for activity impairment. Similarly, for every 16 points by which IBDQ scores improved, WPAI-UC scores for presenteeism, work productivity loss, and activity impairment improved by 8.1, 7.9, and 8.8 percentage points, respectively.

“These findings provide insight into the relationships of a frequently used disease activity measure (the Mayo score) and a HRQoL instrument (IBDQ) with work productivity and activity impairment,” the study authors wrote. “Characterizing and quantifying this relationship will help inform healthcare providers on the impact of UC on a patient’s work and non-work activities.”

Characterizing and quantifying this relationship will help inform healthcare providers on the impact of UC on a patient’s work and non-work activities.

Study limitations include the subjectivity of the Physician’s Global Assessment and the WPAI-UC and the post-hoc nature of the analyses, which may affect generalizability of results to patients with UC in the clinic.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Targownik L, Dubinsky MC, Steinwurz F, et al. Disease activity and health-related quality of life relationships with work productivity in patients with ulcerative colitis in OCTAVE Induction 1&2 and OCTAVE Sustain. J Crohns Colitis. Published online October 22, 2022. doi:10.1093/ecco-jcc/jjac161