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P214. Mesenchymal stromal cells increase the effectiveness of anti-inflammatory therapy and help to increase the duration of remission in newly diagnosed Crohn's disease

L. Lazebnik1, O. Knyazev1, P. Shcherbakov1, I. Ruchkina1, A. Parfenov1, A. Konoplyannikov2

1Central Research Institute of Gastroenterology, Moscow, Russian Federation; 2Medical Radiological Research Center, Obninsk, Russian Federation

Background: The recurrence rate of Crohn's disease (CD) in the first year after diagnosis is 44%. Aim: to assess the impact of culture mesenchymal stromal cells (MSCs) in patients with newly diagnosed CD for the duration of disease remission.

Methods: Divided into two groups of patients with newly diagnosed CD. The first group of MSCs (n = 15) – BC patients who received MSC, the second group – 5‑ASA/GCS (n = 15) – patients who received standard anti-inflammatory therapy with 5‑aminosalicylic acid (5-ASA) and corticosteroids (GCS). Age of patients ranged from 19 to 34 years (Me-22 years), severity of attack of the disease – moderate to severe, the extent damage – ileokolit, ileitis and colitis, the observation time ranged from 28 to 48 months. Clinical activity was assessed by CD index Best (CDAI). Allogeneic MSCs injected culture drip in a dose of 3 million to 1 kg of body weigh.

Results: In 1‑st group CDAI was 242.6±11.7 points in the 2‑nd – 240.9±12.9 points (p = 0.83), CRP levels in 1‑st group was 29.3±6.4 mg/l in the 2‑nd – 27.8±4.8 (p = 0.47). After 1 year of follow CDAI 1‑st group was 70.0±11.0 points in the 2nd – 133.8±22.2 points (p < 0.001), CRP levels in 1‑st group was 6.36±1.5 mg/l in the second – 12.2±2.9 (p < 0.001). After 2 years of follow CDAI 1‑st group was 99.6±19.3 points in the 2‑nd – 147.1±22.1 points (p < 0.001), CRP levels in 1‑st group was 16.0±6.0 mg/l in the 2‑nd – 18.8±4.4 (p = 0.156). After 3 years, the index of Best in 1‑st group was 110.5±21.9 points in the 2‑nd – 180.6±20.3 points (p < 0.001), CRP levels in1-st group was 10.9±2.6 mg/l in the 2‑nd – 16.9±3.0 (p < 0.001). The relative risk (RR) of recurrence in patients with CD who received MSCs (Group 1) compared to the 2‑nd group (5-ASA/GCS) at 1 year was 0.14 (95% CI 0.02–1.02) (p = 0.04), (x2–4.26). RR of recurrence of CD in 2 years of observation – 0.38 (95% CI 0.12–1.15) (p = 0.13), (x2–2.3), after 3 years – 0.36 (95% CI 0.15–0.89) (p = 0.03), (x2–4.8).

Conclusions: MSC increase the efficiency of anti-inflammatory therapy in patients with newly diagnosed Crohn's disease, helping to increase the duration of disease remission. Risk of recurrence of CD 3 years after remission is 3 times lower in patients who received MSC.