P384 Postoperative Endoscopic Recurrence In Patients With Crohn’s Disease After “Curative” Ileocecal Resection on Prophylaxis Treatment With Either Anti-TNFs, Vedolizumab or Ustekinumab: A Real-World Multicentre European Study

Abstract Background Endoscopic post-operative recurrence (ePOR) is common following ileocecal resection (ICR) in patients with Crohn’s disease (CD), reaching up to, 70% at, 1-year. In clinical trials, prophylaxis anti-TNF therapies demonstrated a decrease ePOR to around, 20% Here we aimed compare the effectiveness of vedolizumab (VDZ) and ustekinumab (UST) anti-TNFs for preventing after curative ICR adults CD real-world setting. Methods This was retrospective multicenter study, assessing >17years who underwent between, 2015–2019, started within six months surgery, an ileocolonoscopy ≥ four prophylaxis. (Rutgeerts score i2 or colonic-segmental-SES-CD≥6) assessed 12, 24, 36-months periods post-surgery. Multivariate logistic regression used assess risk factors ePOR, IPTW performed between agents. Results Included, 297 [53.9% males, age-at-diagnosis, 24(19–32) years (median;IQR), age-at-ICR, 34(26–43)years 18.5% current-smokers]. Of these, 17.2% had previous-ICR, 8.1% were biologic naïve, 65.7% experienced, and, 28.6% exposed 2 biologics. Overall, 224, 39 34 received respectively anti-TNFs, VDZ UST prevention POR. Patients on more likely be experienced post previous-ICR. rates entire cohort, anti-TNF, were:, 41.8%, 40.2%, 33%, 61.8% 12-months, 49.0%, 46.5%, 44.4%, 72.4% 24- months, 48.6%, 47.9%, 44.0% 62.5% 36-months, respectively. Risk ePOR: past infliximab (Adj.OR =1.73 [95% CI:, 1.01–2.97], p=0.045) adalimumab = 2.32 1.35–4.01], p=0.002), technical aspects anastomosis. After controlling disparities groups by method 12-months comparable vs UST. However, comparison revealed that at higher (OR=3.75 1.33–10.6]), p=0.012. Conclusion Prevention successful ~60% period. consisted distinct, refractory group ePOR. Post-operative treatment resulted similar when compared severity.