OP11 Ileocecal resection for recently diagnosed ileocecal Crohn’s disease is associated with improved long-term outcomes compared to anti-tumor necrosis factor therapy: a population-based study

Abstract Background Early treatment of Crohn’s disease (CD) often involves biologics such as anti-tumor necrosis factor (anti-TNF) agents. Ileocecal resection (ICR), while a therapeutic option in early CD, is generally reserved for complicated CD or when medical fails. We aimed to compare long-term outcomes ICR and anti-TNF therapy index ileocecal initiated within one year diagnosis, the Danish nationwide cohort. Methods Using cross-linked registers, we identified all individuals who lived Denmark were diagnosed with ileal between 2003 2018. included underwent received drugs diagnosis. excluded patients did not have pathology information confirming region. The primary outcome was composite CD-related hospitalization, systemic corticosteroid exposure, surgery, perianal conducted Cox proportional hazards regression analyses two groups after adjusting potential confounders. also determined proportion on immunomodulator (IMM), anti-TNF, no at 5 years ICR. Results Of 16,443 2018, 581 (3.5%) 698 (4.2%) confirmed region treatment, respectively. occurred 273 (IR 110.3/100,0 person (PY)) group 318 201.9/100,0 PY) group. risk 33% lower compared (aHR 0.67; 95% CI 0.54, 0.83), demographic clinical variables. On analysis individual outcomes, associated reduced exposure but hospitalization ICR, that IMM, follow up 47.5%, 17.1%, 50.3%, Conclusion These data support role an challenge current paradigm reserving surgery refractory intolerant medications. Further studies will help identify characteristics needed