CONQUER Scleroderma: association of gastrointestinal tract symptoms in early disease with resource utilization

Sarah Luebker; Tracy M Frech; Shervin Assassi; Brian Skaug; Jessica K Gordon; Kimberly Lakin; Elana J Bernstein; Yiming Luo; Virginia D Steen; Ami A Shah; Laura K Hummers; Carrie Richardson; Duncan F Moore; Dinesh Khanna; Flavia V Castelino; Lorinda Chung; Puneet Kapoor; Faye N Hant; Victoria K Shanmugam; John M VanBuren; Jessica Alvey; Monica Harding; Ankoor Shah; Ashima Makol; Dorota Lebiedz-Odrobina; Julie K Thomas; Elizabeth R Volkmann; Jerry A Molitor; Nora Sandorfi

doi:10.1093/rheumatology/kead176

CONQUER Scleroderma: association of gastrointestinal tract symptoms in early disease with resource utilization

Rheumatology (Oxford). 2023 Oct 3;62(10):3433-3438. doi: 10.1093/rheumatology/kead176.

Authors

Sarah Luebker^{1

2}, Tracy M Frech^{1

2}, Shervin Assassi³, Brian Skaug³, Jessica K Gordon⁴, Kimberly Lakin⁴, Elana J Bernstein⁵, Yiming Luo⁵, Virginia D Steen⁶, Ami A Shah⁷, Laura K Hummers⁷, Carrie Richardson⁸, Duncan F Moore⁸, Dinesh Khanna⁹, Flavia V Castelino¹⁰, Lorinda Chung¹¹, Puneet Kapoor¹¹, Faye N Hant¹², Victoria K Shanmugam¹³, John M VanBuren¹⁴, Jessica Alvey¹⁴, Monica Harding¹⁴, Ankoor Shah¹⁵, Ashima Makol¹⁶, Dorota Lebiedz-Odrobina¹⁷, Julie K Thomas¹⁷, Elizabeth R Volkmann¹⁸, Jerry A Molitor¹⁹, Nora Sandorfi²⁰

Affiliations

¹ Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
² Department of Medicine, Tennessee Valley Health Care System, Veterans Affair Medical Center, Nashville, TN, USA.
³ Division of Rheumatology, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
⁴ Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York City, NY, USA.
⁵ Division of Rheumatology, Department of Medicine, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, New York, NY, USA.
⁶ Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.
⁷ Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁸ Division of Rheumatology, Department of Medicine, Northwestern University, Chicago, IL, USA.
⁹ Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
¹⁰ Division of Rheumatology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
¹¹ Division of Immunology and Rheumatology, Department of Medicine, Stanford University and Palo Alto VA Health Care System, Palo Alto, CA, USA.
¹² Division of Rheumatology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
¹³ Department of Anatomy, George Washington University, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
¹⁴ Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
¹⁵ Division of Rheumatology and Immunology, Department of Medicine, Duke University, Durham, NC, USA.
¹⁶ Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁷ Division of Rheumatology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
¹⁸ Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
¹⁹ Division of Rheumatic and Autoimmune Diseases, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
²⁰ Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Abstract

Objectives: SSc is associated with increased health-care resource utilization and economic burden. The Collaborative National Quality and Efficacy Registry (CONQUER) is a US-based collaborative that collects longitudinal follow-up data on SSc patients with <5 years of disease duration enrolled at scleroderma centres in the USA. The objective of this study was to investigate the relationship between gastrointestinal tract symptoms and self-reported resource utilization in CONQUER participants.

Methods: CONQUER participants who had completed a baseline and 12-month Gastrointestinal Tract Questionnaire (GIT 2.0) and a Resource Utilization Questionnaire (RUQ) were included in this analysis. Patients were categorized by total GIT 2.0 severity: none-to-mild (0-0.49); moderate (0.50-1.00), and severe-to-very severe (1.01-3.00). Clinical features and medication exposures were examined in each of these categories. The 12-month RUQ responses were summarized by GIT 2.0 score categories at 12 months.

Results: Among the 211 CONQUER participants who met the inclusion criteria, most (64%) had mild GIT symptoms, 26% had moderate symptoms, and 10% severe GIT symptoms at 12 months. The categorization of GIT total severity score by RUQ showed that more upper endoscopy procedures and inpatient hospitalization occurred in the CONQUER participants with severe GIT symptoms. These patients with severe GIT symptoms also reported the use of more adaptive equipment.

Conclusion: This report from the CONQUER cohort suggests that severe GIT symptoms result in more resource utilization. It is especially important to understand resource utilization in early disease cohorts when disease activity, rather than damage, primarily contributes to health-related costs of SSc.

Keywords: SSc; gastrointestinal tract; health outcomes; health status.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Gastrointestinal Diseases* / etiology
Humans
Registries
Scleroderma, Systemic* / complications
Self Report
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding