DOP82 Biological Treatment Cycles in Crohn’s Disease

Abstract Background There are now a growing number of licensed biological therapies for patients with Crohn’s disease (CD) but given the costs long-term maintenance treatment, as well some concerns about potential side effects, there has been increasing interest in elective treatment discontinuation selected patients, after period sustained remission. Following discontinuation, cases relapse, limited reassuring evidence suggested that remission may often be regained by retreatment same agent. Therefore, concept emerged where cycles therapy might used. If this strategy were applied subgroup at low-risk cycling allow lower, overall drug exposure still enable appropriate control. However, currently, remains uncertainty benefit-risk balance using CD. Methods An expert panel was convened European and Colitis Organisation (ECCO) to review published literature agree series consensus practice positions (CPPs) on topic (biocycling). open-call announced all ECCO members, following which 15 individuals based their expertise, three subgroups formed. The aimed provide evidence-based guidance support shared decision-making. Results A total 14 CPP statements developed comprehensive literature. evaluated multiple different aspects cycling, including risk relapse predictors likely or remission, safety, patient preferences pharmacoeconomic aspects. Discussion preliminary voting round took place, subsequent revision supporting text, followed further meeting final statements. Conclusion With focus preferences, safety costs, considered CD In have findings is need more data routine CD, especially newer agents. particular, randomised, controlled trials comparing current strategies would highly informative. Currently, discussions should individualised, decision-making clinicians.