PREDICTORS AND OUTCOMES OF BIOLOGIC/IMMUNOSUPPRESSIVE THERAPY FOR PSC-ASSOCIATED IBD

Inflammatory bowel disease (IBD) coexists in up to 80% of patients with primary sclerosing cholangitis (PSC). PSC-IBD tends be mild and responsive mesalamine most patients. However, some may require immunosuppressive (IMM) or biologic therapy treat PSC-IBD. The aims this study are investigate the rates, predictors, outcomes biologic/IMM treatment This was a single center, retrospective PSC from 1/1/2012 4/1/2021. Adult (age ≥ 18 years) were included. Primary rates predictors Secondary included cholangitis, clinical remission (per physician global assessment), endoscopic healing (absence ulcers/erosions) who required biologics/IMM. Patients biologics IMM (biologic/IMM group) compared did not Continuous variables using an unpaired Student’s t-test. Categorical Chi-square Fisher’s Exact test as appropriate. A total 106 reviewed 72 (68%) had confirmed study. median age 48 years (IQR 33-59.5) 69.4% male (Table 1). 22 (30.6%) biologic/small molecule (infliximab 6; ustekinumab vedolizumab 5; adalimumab 4; tofacitinib 1) 6 (8.3%) needed thiopurine monotherapy Overall, 28 (38.9%) biologics/IMM In group, 9 (32.1%) small involvement 2 (4.6%) (p=0.002). 7 (25%) overlap autoimmune hepatitis (AIH) 3 (6.8%) for (p=0.04). (64.3%) subjects also treated ursodeoxycholic acid (UDCA) 29 (65.9%) non-biologic/IMM group (p=0.89). At least 1 episode noted 12 (42.9%) 14 (31.8%) (p=0.34). achieved (78.6%) but only (50%). our cohort, third Small associated need biologic/IMM. use resulted over three quarters however half. higher rate larger studies effects different classes on outcomes.