P463 Achieving Remission in Paediatric Inflammatory Bowel Disease (pIBD): Data on Mono- vs. Combination Therapy using the ImproveCareNow (ICN) Data Base
S. Chadokufa*1, B. Huggett1, S. Sider1, N. Shah1, M. Elawad1, F. Kiparissi1, 2
1Great Ormond Street Hospital, Paediatric Gastroenterology, London, United Kingdom, 2University College London Hospitals NHS Foundation Trust, Department of Gastroenterology, London, United Kingdom
The main objectives for managing children with Crohn's disease are to improve quality of life, promote growth, and prevent disease complications by maintaining remission. At the same time medications have significant side effects. A variety of treatment in Paediatric IBD is available either as monotherapy or combination therapy.
The aim of this study using our ICN database was to review the latest management of our pIBD patients identifying the number of patients currently in clinical remission and the treatment we are using to achieve our goal. Our centre joined the ICN collaboration in 2010 to benchmark our outcomes against at present 66 other pIBD Centres looking after a total of over 18 000 pIBD patients.
We retrospectively reviewed our ICN data base of 285 patients diagnosed with IBD at our tertiary Paediatric Gastroenterology Centre. All patients were diagnosed with IBD according to standard clinical and histopathological criteria. We looked into each patient's last clinic appointment.
We identified 206 patients (male n=117, aged 5-17 years, median 11y), 60% had Crohn's Disease (CD), 22% Ulcerative Colitis (UC), 18% IBD unclassified (IBDU.
80.5% (166) were in clinical remission, 15% had mild symptoms, <5% moderate to severe
In the clinical remission group 55 patients (33%) were on monotherapy, as follows: Aza/6-MP n=28, 5 ASA's n=16, MTX n=5, Infliximab n=3, Adalimimab n=3
107 (64.5%) on combination therapies: Aza/6MP and 5 ASA n=45, Aza/6MP and Infliximab n=16, Aza and Adalimumab n=5, MTX and Infliximab n=1, MTX and Adalimumab n=3, MTX and 5 ASA n=3, AZA and 5 ASA and Infliximab n=11, AZA and 5 ASA and Adalimumab n=6, Others n=17.
4 patients (2.5%) were not on any medication.
No difference in remission rate was seen across CD, UC and IBDU patients.
Overall 80.5% of our patients were in clinical remission, of whom one third were on monotherapy only.
Our ICN database is a valuable tool in capturing our remission rates on mono- and combination therapies, alerting us on treatment failures.