Introduction: Injection site reactions (ISRs) are a known adverse event (AE) of injectable therapies in patients with Crohn's disease (CD) and ulcerative colitis (UC), but real-time and long-term study of this AE remains difficult. The Twitter Streaming Application Programming Interface (API) has been previously used to monitor AEs in other diseases. The Twitter API (TAPI) gives access to ˜1% of all tweets and provides for large-scale data collection. We used the TAPI to describe injection site reactions in IBD patients. Methods: The Twitter Spritzer Streaming API and Search API were utilized together in order to collect tweets relevant to IBD and subcutaneous medications (adalimumab [ADA], golimumab, certolizumab pegol [CZP], and methotrexate [MTX]). User IDs were extracted to determine unique users. Retweets from all users and tweets from pharmaceutical companies were excluded. Disease information was extracted from tweets.Figure 1Results: Over two months, 220 tweets were collected from 104 unique users. 138 tweets (63%) were sent to Twitter from pharmaceutical companies and excluded. 54/220 tweets from 38 unique users (37%) met inclusion criteria (a 25% yield). Of these users, 27 were CD patients, 5 were UC patients, and 6 did not specify their type of IBD. The majority of Twitter users reported the use of ADA (n=28), 2 reported using CZP, and 8 reported using MTX. All users reported medication use by brand name except when describing MTX. 20 tweets (37%) contained information about time points. This included referencing injection schedules (n= 15), medication shipment dates (n=1), and changes in therapy (n=4). Two ISRs were reported, both in the use of ADA. The first ISR occurred in an individual with UC during the initial loading dose and was characterized by pain in their thighs for the duration of the day. No photo was included. The second occurred in a user with unspecified IBD and described slight itching and a reaction duration of greater than two weeks. A photo was uploaded confirming the ISR (Figure). Conclusion: Using Twitter to study injection site reactions identified a low number of reported AEs of interest, but provides a framework for directed inquiry for future use. The Streaming API can target these individuals and record important time points, changes in therapy, and use brand names as keyword filters.