P697 De-escalating therapy in inflammatory bowel disease: Results from an observational study in clinical practice

Abstract Background Combination therapy with an immunomodulator (IMM) and anti-TNF agent (specifically infliximab) is recommended in Crohn’s disease (CD) ulcerative colitis (UC) patients to improve efficacy reduce immunogenicity. Combo increases the risk of adverse events therefore attempts are made de-escalate clinical practice. There scarce data about relapse rates after discontinuation either IMM or among long-term remission under combination therapy. The aims this study were assess a cohort UC CD long-standing identify predictive factors for relapse. Methods This retrospective unicentric that included on sustained at least 6 months. stopped upon treating-physician decision collected until last follow-up. Relapse was defined as onset clinical, biological, endoscopic radiological activity, leading therapeutic intervention. survival without represented by Kaplan–Meier curve analyzed log rank test. Hazard ratios (HR) estimated Cox proportional hazard regression analyses reported 95% confidence intervals (CI). Results Eighty-eight (60 (68.2%), 28 (31.8%) included. Demographic characteristics shown tables 1 2. Forty-eight (54.5%) discontinued 40 (45.5%) anti-TNF. Median time follow-up 33 months (IQR 18.00-55.75). During follow-up, rate 16.7% group 52.5% (p<0.001) (Figure 1). 38.50 19.75-58.5) 24.50 10.25-42.75), respectively (p=0.036). In multivariate analysis, only factor (HR=4.99; CI=1.11–14.07) (Table 3). Among who relapsed discontinuation, response reintroduction drug achieved 78.6% (11/14) safety issues. Conclusion Discontinuation led significantly higher compared IMM. Retreatment effective safe.