P620 Assessment of predictors of the need for biologic therapy in patients with inflammatory bowel disease: a single tertiary centre experience
S. Raimundo Fernandes*, L. Correia, P. Moura Santos, A. Rita Gonçalves, A. Valente, C. Baldaia, J. Velosa
Centro Hospitalar Lisboa Norte, Gastrenterology, Lisbon, Portugal
Crohn’s disease (CD) and ulcerative colitis (UC) represent chronic inflammatory diseases affecting the bowel. Anti-tumour necrosis factor (TNF) agents have revolutionised the way of treating inflammatory bowel diseases refractory to conventional medications. We aimed to evaluate demographic and clinical predictors of the need for biologic therapy in patients with CD and UC.
This was a retrospective analysis study including 1 006 patients with an established diagnosis of CD (616) and UC (398) followed in a single centre. Demographic and clinical data were retrieved from patient’s medical charts. Logistic regression analysis was performed to identify potential predictors of requiring biologic therapy.
In total, 234 (38.0%) patients with CD and 57 (14.3%) patients with UC required anti-TNF therapy (p < 0.001). In regression analysis, predictors of requiring anti-TNF in patients with CD were disease behaviour (OR 1.351 CI 95% [1.032–1.770], p = 0.029), upper gastrointestinal involvement (OR 2.377 CI 95% [1.264–4.470], p = 0.007), perianal disease (OR 2.582 CI 95% [1.650–4.040], p < 0.001), and thiopurine intolerance (OR 3.185 CI 95% [1.582–6.415], p = 0.001). In patients with UC only, steroid dependency was associated with anti-TNF therapy (OR 3.587 CI 95% [1.103–1.663], p = 0.034). Predictors common to both CD and UC included early age of diagnosis (OR 0.957 CI 95% [0.944–0.970], p < 0.001) and immunomodulatory therapy (OR 11.801 CI 95% [7.1211–9.556], p < 0.001).
Duration of disease, immunomodulatory therapy, and intolerance to thiopurines affected the utilisation of biologic therapies in both CD and UC. Disease behaviour and upper gastrointestinal and perianal disease are risk factors in patients with CD. Our results are in accordance with the published literature.