Effects of anti-TNF therapy and immunomodulators on anxiety and depressive symptoms in patients with inflammatory bowel disease: a 5-year analysis
Authors: 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 , Abdelrahman Karim , Ademi Gentiana , Aepli Patrick , Thomas Amman , Anderegg Claudia , Antonino Anca-Teodora , Archanioti Eva , Arrigoni Eviano , Aslan Nurullah , Bakker de Jong Diana , Balsiger Bruno , Barry Mamadou-Pathé , Bastürk Polat , Bauerfeind Peter , Becocci Andrea , Bengoa José M. , Biedermann Luc , Binek Janek , Blattmann Mirjam , Boehm Stephan , Boldanova Tujana , Borovicka Jan , Braegger Christian P. , Brand Stephan , Bravo Francisco , Brügger Lukas , Brunner Simon , Bühr Patrick , Burk Sabine , Burri Emanuel , Butter Matthias , Buyse Sophie , Cao Dahlia-Thao , Carstens Ove , Criblez Dominique H. , D’Angelo Fabrizia , Saussure Philippe de , Degen Lukas , Delarive Joakim , Doerig Christopher , Dora Barbara , Drerup Susan , Ducrey Carole , El-Wafa Ali , Engelmann Matthias , Erdmann-Voisin Aude , Felley Christian , Fliegner Markus , Fraga Montserrat , Franc Yannick , Frei Pascal , Frei Remus , Fried Michael , Froehlich Florian , Ivano Furlano Raoul , Garzoni Luca , Geyer Martin , Girardin Marc , Golay Delphine , Good Ignaz , Graf Bigler Ulrike , Godat Sébastien , Greuter Thomas , Gysi Beat , Haarer Johannes , Halama Marcel , Haldemann Janine , Heer Pius , Heimgartner Benjamin , Helbling Beat , Hengstler Peter , Herzog Denise , Hess Cyrill , Hessler Roxane , Heyland Klaas , Hinterleitner Thomas , Hirschi Claudia , Hruz Petr , Juillerat Pascal , Kapoglou Ioannis , Kayser Stephan , Keller Céline , Khalid-de Bakker Carolina , Knellwolf Christina , Knoblauch Christoph , Köhler Henrik , Koller Rebekka , Krieger Claudia , Künzler Patrizia , Kusche Rachel , Serge Lehmann Frank , Macpherson Andrew , Maillard Michel H. , Manz Michael , Martinho Maude , Meier Rémy , Meyenberger Christa , Meyer Pamela , Michetti Pierre , Misselwitz Benjamin , Morell Bernhard , Mosler Patrick , Moschouri Eleni , Mottet Christian , Müller Christoph , Müllhaupt Beat , Musso Leilla , Neagu Michaela , Nichita Cristina , Niess Jan , Nydegger Andreas , Obialo Nicole , Oropesa Cassandra , Peter Ulrich , Peternac Daniel , Marie Petit Laetitia , Pittet Valérie , Pohl Daniel , Porzner Marc , Preissler Claudia , Raschle Nadia , Rentsch Ronald , Restellini Sophie , Richterich Jean-Pierre , Riedmüller Sandra , Risti Branislav , Alain Ritz Marc , Rogler Gerhard , Röhrich Nina , Rossel Jean-Benoît , Roth René , Rueger Vanessa , Sagmeister Markus , Saner Gaby , Sarraj Riad , Sauter Bernhard , Sawatzki Mikael , Scharl Michael , Scharl Sylvie , Schelling Martin , Schibli Susanne , Schlauri Hugo , Schluckebier Dominique , Schmid Daniela , Schmid Sybille , Schnegg Jean-François , Schoepfer Alain , Schreiner Philipp , Seibold Frank , Seirafi Mariam , Semadeni Gian-Marco , Senning Arne , Sokollik Christiane , Sommer Joachim , Spalinger Johannes , Spangenberger Holger , Stadler Philippe , Staub Peter , Staudenmann Dominic , Stenz Volker , Steuerwald Michael , Straumann Alex , Stulz Andreas , Sulz Michael , Tempia-Caliera Michela , Thorens Joël , Truninger Kaspar , Tutuian Radu , Urfer Patrick , Vavricka Stephan , Viani Francesco , Vinzens Fabrizion , Vögtlin Jürg , Von Känel Roland , Vouillamoz Dominique , Vulliamy Rachel , Vullièmoz Marianne , Wiesel Paul , Wiest Reiner , Wöhrle Stefanie , Yilmaz Bahtiyar , Zamora Samuel , Zander Silvan , Zeitz Jonas , Zimmermann Dorothee 
Published: August 2021

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.