P695 Effectiveness and Safety of Combination Biologic or Small Molecule Therapy in Inflammatory Bowel Disease

Abstract Background Biologic and small molecule therapies have revolutionised the treatment of inflammatory bowel disease (IBD). Despite these advances, there appears to be a therapeutic ceiling with single agent therapy up 50% patients failing achieve long term remission. Combination two biologic or agent, differing mechanisms action, has potential improve IBD outcomes. Information on effectiveness safety this strategy in remains limited. Methods A retrospective, multicentre study was carried out at five Irish Academic Centres within Initiative Network. use defined as concomitant biologics one licenced undergoing clinical trial assessment for IBD. Patients who had received combination were identified from institutional databases. Review records performed demographic data collected. persistence considered proxy successful outcome. Adverse events documented. P values < 0.05 significant analyses. Results The cohort included 85 patients; 70% Crohn’s (CD), 30% ulcerative colitis (UC); median (IQR) number prior 3 (2 – 3); follow 40.71 weeks (13.68 82.86). Further baseline characteristics are described Figure 1. 97 trials undertaken patients. 13 different regimes utilised ustekinumab & vedolizumab being most common regimen. 76.5% (n=65 patients) remained last up. Higher rates discontinuation (p=0.04) shorter time observed UC compared CD (HR 0.48 [95% CI 0.21-1.11], p<0.05). 3.1% developed serious opportunistic infection. No deaths intensive care unit admissions occurred during Conclusion is an effective acceptable profile refractory Randomised controlled required clearly define role management