P1211 Factors Associated with the Optimization of Biological Therapy in Crohn's Disease and Ulcerative Colitis: Insights from the National GEDIIB Patient Registry in Brazil
Authors: Froes R , Yukie Sassaki L , Ribas Andrade A , Gouvea Faria M A , Luz Parente J M , Pandolfo Zabot G , Almeida N , Coelho Demetrio W , Marques dos Santos C H , Loureiro Salgado V C , Siffert Pereira de Souza H , Guilherme Cancela Penna F , Serafim Parra R , Menegassi V , Maximiano F L , Oliveira Santana G , Bafutto M , Luporini R L , Machado de Souza MACHADO DE SOUZA M , Zaltman C , Tavares da Rocha Loures M , Botelho Quaresma A , Marques Andrade G , Lima Junior S , Ferreira de Almeida e Borges V , Vieira M C , Sari Cassol O , Miszputen S , Prudente de Andrade L , Jacarandá de Faria R , Flores C 
Published: January 2025

Abstract

Background
Biological therapy has revolutionized the treatment of inflammatory bowel disease (IBD); however, a subset of patients still requires therapy optimization to achieve therapeutic goals. This study aimed to identify patients who underwent biological therapy optimization (TO) and compare their characteristics with those who did not require such adjustments.

Methods
A retrospective study was conducted using data from the national patient registry of GEDIIB (Brazilian Crohn's and Colitis Organization). A total of 1,660 patients with Crohn's disease (CD) and 530 patients with ulcerative colitis (UC) undergoing biological therapy were included. The need for TO was determined based on clinical or endoscopic criteria specific to each participating center. Statistical analyses included association tests and Poisson regression.

Results
The need for TO was more frequent among patients with CD(33.3%) compared to those with UC (26.2%) (p=0.003). In CD, optimization was associated with younger age (p=0.016), stenosing (p=0.03) or penetrating behavior (p=0.015), perianal disease (p&lt;0.001), presence of fistula (p=0.019), and prior surgery (p=0.044). Table 1 displays the adjusted frequency ratio (FR) for TO in CD patients. After adjusting for confounding factors, the most significant predictors for optimization in CD were younger age, perianal disease, and prior surgery. In UC, optimization was associated with younger age (p=0.013), pancolitis extent (p&lt;0.001), previous surgery (p=0.037), hospitalization (p=0.025), and chronic liver disease (p=0.024). Table 2 presents the adjusted FR for therapy optimization in UC patients. After adjustment, the factors most strongly associated with optimization in UC were prior surgery and chronic liver disease.

Conclusion
Approximately 30% of patients required optimization of biological therapy. This need was associated with younger age, a more severe disease profile, and the presence of complications, such as perianal disease in CD, as well as a history of surgery and hospitalization in UC.

References
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