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P368. Are inherited thrombotic risk factors associated with fibrostenosis in Crohn's disease?

G. Novacek, P. Papay, W. Miehsler, W. Reinisch, C. Lichtenberger, R. Sunder-Plassmann, H. Vogelsang, C. Gratzer, C. Mannhalter

Medical University of Vienna, Vienna, Austria

Aim: Fibrostenotic lesions are common complications in Crohn's disease (CD) often requiring surgery. Inherited thrombotic risk factors are associated with fibrosis in other chronic inflammatory diseases. The aim of the study was to assess whether inherited thrombotic risk factors are associated with fibrostenosis in CD.

Material and Methods: Clinical data on 529 CD patients were collected retrospectively. Subjects were tested for and grouped according to the presence of factor V Leiden (FVL), the prothrombin G20210A and the methylenetetrahydrofolate reductase C677T mutation (MTHFR). The primary endpoint was the first intestinal CD-related surgery with presence of fibrostenosis. The diagnosis of fibrostenosis was based on surgical, pathological and histopathological reports. A Cox-proportional hazards model was used for statistical analysis.

Results: Thirty-two (6.1%, heterozygous 30, homozygous 2) patients were carriers of FVL, 19 (3.6%, all heterozygous) carried the prothrombin variant, and 318 (60.1%) the MTHFR variant (243 heterozygous, 75 homozygous). Three-hundred-three (57.3%) patients underwent intestinal surgery. Fibrostenosis was identified in 219 (72.3%) surgical specimen. The rate of first intestinal surgeries with fibrostenosis tended to be more frequent in patients with the homozygous 677TT MTHFR mutation (HR 1.39, 95% CI 0.98–1.97; P = 0.067). After adjustment for potential confounders homozygous 677TT MTHFR mutation did not remain a risk factor for intestinal surgery with fibrostenosis (HR 1.23, 95% CI 0.77–1.98; P = 0.387). FVL and the prothrombin variant had no influence on the primary endpoint.

Conclusion: The MTHFR 677TT mutation, factor V Leiden and the prothrombin G20210A mutation are not associated with fibrostenosis in CD.