The impact of biological therapy for inflammatory bowel disease on patients' quality of life and family relationships

Improving quality of life (QoL) is a priority goal in the treatment of inflammatory bowel disease (IBD) in children. The impact of genetically engineered biological therapy (GEBT) on the psychosocial domains of QoL in the Russian population remains insufficiently studied, particularly in the context of family functioning. Objective. To determine the impact of biological therapy on the quality of life of children with inflammatory bowel disease and their families based on the analysis of data from the IMPACT-III, PedsQL 4.0 Generic Core Scales, and PedsQL Family Impact Module questionnaires. Patients and methods. A single-center, cross-sectional, prospective study was conducted involving 77 patients (8–17 years old) with a verified diagnosis of IBD (Crohn's disease – 44, ulcerative colitis – 33). Patients were divided into groups: group 1 (GEBT + baseline therapy, n = 31) and group 2 (isolated baseline therapy, n = 46). The disease-specific IMPACT-III questionnaire, the generic PedsQL 4.0 Generic Core Scales, and the PedsQL Family Impact Module (PedsQL FIM) for parents were used. Results. No statistically significant differences were found in the total IMPACT-III score between the GEBT and baseline therapy groups (76.0 (65.5; 85.0) vs. 71.0 (61.3; 79.8); p = 0.105). A significant advantage of GEBT was revealed in the “Emotional Functioning” domain (IMPACT-III): 76.0 (64.5; 84.0) vs. 66.0 (47.0; 75.0) points (p = 0.026; r = -0.30). No intergroup differences were recorded in general QoL indicators (PedsQL) and family functioning (PedsQL FIM) (p > 0.05). A strong correlation was found between IMPACT-III and PedsQL (ρ = 0.643; p < 0.001). No significant correlations were identified between subjective QoL and clinical activity indices (PCDAI/PUCAI) (p > 0.05). Conclusion. Biological therapy is associated with an improvement in the emotional status of children with IBD, which is more accurately captured by the disease-specific instrument. The absence of a correlation between clinical activity and QoL highlights the independent role of psychosocial factors, necessitating the integration of psychological support into standard patient management protocols. Key words: Crohn's disease, inflammatory bowel disease, children, quality of life, ulcerative colitis, biological therapy, IMPACT-III, PedsQL