S798 Indirect Effects of Tofacitinib on Work Productivity in Patients with Ulcerative Colitis: A Mediation Analysis Between Work Productivity and the Inflammatory Bowel Disease Questionnaire
Notice bibliographique
Résumé
Introduction: Tofacitinib is an oral small molecule JAK inhibitor for the treatment of UC. Tofacitinib induction treatment has been shown to improve work productivity in patients (pts) with UC. However, it is unknown whether improvements in work productivity are fully explained by changes in the Inflammatory Bowel Disease Questionnaire (IBDQ) or if other factors not captured by these changes contribute. Methods: We evaluated the interrelationship between IBDQ domains (bowel, emotional, social, and systemic) and Work Productivity and Activity Impairment-UC (WPAI-UC) components (overall work productivity loss and activity impairment) among pts in the Phase 3, 8-week induction studies that evaluated tofacitinib as induction therapy for UC (OCTAVE Induction 1&2; NCT01465763; NCT01458951). A mediation model used IBDQ domains as mediators of the treatment effect on WPAI-UC components as outcomes. Work productivity loss and activity impairment can be viewed as complementary outcomes covering work and other daily activities, respectively. Analyses used all available pooled data from Week 8 in pts receiving tofacitinib/placebo. Results: There were 490 and 1,083 pts available for analysis in the models assessing work productivity loss and activity impairment, respectively. For the models evaluating work productivity loss (Figure a) and activity impairment (Figure b), the effects of tofacitinib were fully mediated via IBDQ domains; the largest effects were via the IBDQ social domain, which represented 57.4% and 58.4% of the effects of tofacitinib on work productivity loss and activity impairment, respectively (Figure a and Figure b, respectively). The impact of tofacitinib via the IBDQ emotional domain did not affect work productivity loss or activity impairment. Conclusion: This analysis suggests that the effects of tofacitinib induction therapy on work productivity loss and activity impairment in pts with UC were fully mediated via IBDQ bowel, social, and systemic domains. These findings provide insights into the interrelationship between IBDQ domains and WPAI-UC and may help inform healthcare providers on the impact of UC therapies on pts' work and leisure activities.Figure 1.: Summary of indirect (mediated through IBDQ domains) effects of tofacitinib vs placebo on the a) work productivity loss and b) activity impairment WPAI-UC components as a percentage of the total treatment effect. The WPAI-UC is a self-administered six-item questionnaire that generates four metrics: absenteeism (work time missed), presenteeism (impairment whilst working), productivity loss (overall work impairment from the combination of absenteeism and presenteeism), and activity impairment (non-work activity impairment). WPAI-UC component scores are expressed as percentages, with a higher percentage indicating greater impairment and less productivity. The IBDQ evaluates disease-related quality of life by 32 items over four domains: bowel (total domain score ranges from 10 to 70), emotional (total domain score ranges from 12 to 84), social (total domain score ranges from 5 to 35), and systemic (total domain score ranges from 5 to 35). For the total score (ranges from 32 to 224) and each domain, a higher score indicates a better quality of life. IBDQ, Inflammatory Bowel Disease Questionnaire; WPAI-UC, Work Productivity and Activity Impairment-Ulcerative Colitis
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,012 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,023 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».