924 Long-Term Outcomes of Top-Down Versus Step-up Treatment in Newly Diagnosed Crohn's Disease: Final Data

Abstract

G A A b st ra ct s variables, healthcare utilization, comorbidities and baseline immunosuppressive medication use, to assess the relative effectiveness and safety of IFX and ADA. Results: Our cohort comprised 1869 biologic-naive UC pts (age, 42.3±16.0y; 50.8% males) who were prescribed IFX (n=1470) or ADA (n=399) as first-line anti-TNF agents, and followed over median of 1.7 years (IQR, 0.9-3.0). Baseline demographics, healthcare utilization (outpatient, inpatient or emergency room visits; imaging and endoscopic procedures), comorbidities and prior medication exposure was comparable between the two groups (Table 1). As compared to ADA, pts treated with IFX were significantly less likely to require IBD-related hospitalization and new steroid prescription, after adjusting for baseline demographic variables, healthcare utilization, comorbidities and baseline immunosuppressive medication use (Table 2). There was no significant difference in the risk of abdominal surgery, though the number of events was small. Persistence on therapy at 6 months was significantly higher for IFX (61.4%) compared to ADA (14.8%). The incidence of serious infections was comparable between IFXand ADA-treated pts (incidence rate per 100 patient years: IFX vs. ADA, 1.49 vs. 2.25). Conclusion: In a large cohort of biologic-naive UC pts, IFX appears superior to ADA as first-line anti-TNF agent for important clinically relevant outcomes, without increased risk of serious infections. This requires further validation in randomized trials. Baseline characteristics of biologic-naive patients with ulcerative colitis.