A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis.
Study Goal
The researchers aimed to determine if mindfulness-based stress reduction (MBSR) could reduce flare-ups and improve quality of life in patients with ulcerative colitis (UC) in remission, particularly those with high stress reactivity.
Results Summary
MBSR did not significantly affect overall flare-up rates or severity in UC patients but showed benefits in reducing flare-ups among those with high perceived stress and urinary cortisol. It also improved quality of life during flare-ups by mitigating their negative impact.
Population
Patients with moderately severe UC in remission.
Effective Dosage
Not specified
Duration
1 year
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based stress reduction (MBSR) | no change | rate or severity of flare-ups | UC patients in remission | null | did not affect | #1 |
mindfulness-based stress reduction (MBSR) | decrease | proportion of participants with at least one flare-up | those with top tertile urinary cortisol and baseline perceived stress | 30 vs. 70% | decreased | #2 |
mindfulness-based stress reduction (MBSR) | decrease | stress | MBSR patients who flared | null | demonstrated significantly lower stress | #3 |
mindfulness-based stress reduction (MBSR) | no change | Inflammatory Bowel Disease Quality of Life Questionnaire during flare | null | null | prevented a drop | #4 |
mindfulness-based stress reduction (MBSR) | decrease | flare-ups | those with high stress reactivity (high perceived stress and urinary cortisol) during remission | null | might be effective | #5 |
mindfulness-based stress reduction (MBSR) | increase | QOL in UC patients | UC patients | null | appears to improve | #6 |
BACKGROUND/AIMS: The primary therapeutic goals in ulcerative colitis (UC) are to maintain excellent quality of life (QOL) by treating flare-ups when they occur, and preventing flare-ups. Since stress can trigger UC flare-ups, we investigated the efficacy of mindfulness-based stress reduction (MBSR) to reduce flare-ups and improve QOL. METHODS: Patients with moderately severe UC, in remission, were randomized to MBSR or time/attention control. Primary outcome was disease status. Secondary outcomes were changes in markers of inflammation and disease activity, markers of stress and psychological assessments. RESULTS: 55 subjects were randomized. Absence of flares, time to flare and severity of flare over 1 year were similar between the two groups. However, post hoc analysis showed that MBSR decreased the proportion of participants with at least one flare-up among those with top tertile urinary cortisol and baseline perceived stress (30 vs. 70%; p < 0.001). MBSR patients who flared demonstrated significantly lower stress at the last visit compared to flared patients in the control group (p = 0.04). Furthermore, MBSR prevented a drop in the Inflammatory Bowel Disease Quality of Life Questionnaire during flare (p < 0.01). CONCLUSION: MBSR did not affect the rate or severity of flare-ups in UC patients in remission. However, MBSR might be effective for those with high stress reactivity (high perceived stress and urinary cortisol) during remission. MBSR appears to improve QOL in UC patients by minimizing the negative impact of flare-ups on QOL. Further studies are needed to identify a subset of patients for whom MBSR could alter disease course.