A0252 - Impact of Abdominal Symptoms in Patients With Chronic Idiopathic Constipation (CIC) in the United States

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

DT

Douglas CA Taylor, MBA

Ironwood Pharmaceuticals, Inc.
Boston, MA

Brian E. Lacy, MD, PhD, FACG¹, Yanqing Xu, MS, PhD², Douglas C. Taylor, MBA³, Katherine J. Kosch, RPh⁴, Rachel Dobrescu, BA⁵, Amy Morlock, MA⁵, Robert Morlock, PhD⁶, Ceciel Rooker, BS⁷
¹Mayo Clinic, Jacksonville, FL; ²AbbVie, Inc., North Chicago, IL; ³Ironwood Pharmaceuticals, Inc., Cambridge, MA; ⁴AbbVie Inc., North Chicago, IL; ⁵Acumen Health Research Institute, Ann Arbor, MI; ⁶YourCareChoice, Ann Arbor, MI; ⁷International Foundation for Functional Gastrointestinal Disorders, Milwaukee, WI

Introduction: Patients with CIC report a variety of abdominal symptoms beyond reduced stool frequency or straining. However, our understanding of these additional symptoms is limited. This study examined the impact of abdominal symptoms on patients with CIC.

Methods: A cross-sectional, on-line health survey collected data from 8/2020-12/2021 on US adults. CIC patients were defined using Rome IV criteria. Endpoints assessed were care, symptom burden and satisfaction with control, health care provider (HCP) management and treatment of abdominal symptoms. Categorical data were described by percentage; continuous data were described by means and standard deviation.

Results: Of 29,359 total participants, 9.2% (n=2,696) met criteria for CIC. CIC patients were primarily female (68.4%), White (80.9%), with a mean age of 45.1 years. Of CIC patients who sought care in the past year (58.9%), 33.1% sought care due to not getting adequate relief of and/or worsening abdominal symptoms. Of CIC patients who had an ER visit or hospitalization in the past year (15.7%) (Table 1), abdominal pain (84.1%), abdominal discomfort (51.2%) and abdominal bloating (42.2%) were the most common reported reasons. 91.1% of CIC patients took a medication in the past year due to abdominal pain (63.4%), abdominal discomfort (62.2%) or abdominal bloating (45.2%). Abdominal discomfort was the symptom most experienced (58.4%), while abdominal pain was the most bothersome symptom (26.5%) and the predominant symptom limiting ability to work or conduct household chores (33.6%). CIC patients were slightly more dissatisfied than satisfied with overall control of their abdominal symptoms (37.5% vs 36.1%), and more satisfied than dissatisfied with HCP management of their abdominal symptoms (49.7% vs 19.0%). Those currently taking an Rx with or without an OTC were more satisfied with the control of their abdominal symptoms than those currently taking an OTC only (50.6% vs 30.0%) (Figure 1).

Discussion: CIC patients suffer with abdominal symptoms typically associated with IBS-C patients highlighting the overlap of these two common disorders of gut-brain interaction. Symptom impact is high as one-third of CIC patients sought care due to abdominal symptoms, and abdominal symptoms were the most-reported reasons for ER visits or hospitalizations.

Figure: Figure 1 Satisfaction with Control, HCP Management and Treatment of Abdominal Symptoms

	Rome IV CIC Cohort (N=2,696)
	%	N
Female	68.4%	1,843

Age, mean (SD)	45.1	(16.8)

Black or African American	10.6%	286
White	80.9%	2,180
Other	8.5%	230

Proportion of Hispanic, Latino or Spanish origin	10.0%	269

Northeast	18.7%	504
Midwest	22.5%	607
South	38.2%	1,031
West	20.5%	554

Charlson Comorbidity Index (CCI) score, mean (SD)	0.8	(1.6)

Body Mass Index (BMI) (lbs/in²), mean (SD)	27.8	(7.3)

Median household income (Census derived from zip code), mean (SD)	64,556	(26,352)

Proportion educated more than high school	75.5%	2,036

Proportion employed per Work Productivity and Impairment (WPAI) (1)	54.3%	1,111

Sought care for bowel and/or abdominal symptoms in the past 12 months	58.9%	1,589

ER visit or hospitalization for bowel and/or abdominal symptoms, past 12 months	15.7%	422
(1) Question fielded 12/20-12/21; n=2047

Table: Table 1. Characteristics of Patients with CIC

Disclosures:

Brian Lacy: Allakos – Advisory Committee/Board Member. Allergan Pharmaceuticals – Advisory Committee/Board Member. Arena Pharmaceuticals, Inc. – Advisory Committee/Board Member. Cosmos – Advisory Committee/Board Member. Ironwood Pharmaceuticals, Inc. – Advisory Committee/Board Member. Salix Pharmaceuticals, Inc. – Advisory Committee/Board Member. Viver Health – Consultant.

Yanqing Xu: AbbVie, Inc. – Employee, Stock Options.

Douglas Taylor: Ironwood Pharmaceuticals, Inc. – Employee, Stock Options.

Katherine Kosch: AbbVie Inc. – Employee, Stock Options.

Rachel Dobrescu indicated no relevant financial relationships.

Amy Morlock indicated no relevant financial relationships.

Robert Morlock indicated no relevant financial relationships.

Ceciel Rooker indicated no relevant financial relationships.

Brian E. Lacy, MD, PhD, FACG¹, Yanqing Xu, MS, PhD², Douglas C. Taylor, MBA³, Katherine J. Kosch, RPh⁴, Rachel Dobrescu, BA⁵, Amy Morlock, MA⁵, Robert Morlock, PhD⁶, Ceciel Rooker, BS⁷. A0252 - Impact of Abdominal Symptoms in Patients With Chronic Idiopathic Constipation (CIC) in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.