P724 Upadacitinib is Effective and Safe in Tofacitinib-Experienced Patients with Ulcerative Colitis: A Prospective Real-World Experience

Abstract

citation ID: jjac190.0853 P723 Background: Biologics are widely used for paediatric Crohn's disease (CD) and are highly effective; however, primary inefficacy and the emergence of secondary inefficacy during long-term use remain challenges. Although it is desirable for biologics used in paediatric patients to be safe and usable long-term, there are few detailed reports on the comparison of persistence rates of biologics in paediatric patients. Methods: This was a multicentre prospective cohort study using a web-based registry system in Japan that was performed between October 2012 and March 2020. New paediatric inflammatory bowel disease patients diagnosed at less than 18 years of age were enrolled from 23 Japanese hospitals. The persistence rates of the first biologics (Infliximab: IFX and Adalimumab: ADA), and the second biologics (IFX, ADA, and Ustekinumab: UST) were analysed. Patients with unknown outcomes were excluded. Results: We enrolled 185 patients with CD as the final diagnosis, and 109 (59%) received biologics during the observation period. As the first biologic, IFX was used in 52 (45%) patients, ADA in 52 (45%), UST and Vedolizumab (VED) in one, respectively, and the biologic in one patient was unidentified. The 1-, 3-and 5-year persistence rates of IFX and ADA as the first biologic were 90%, 70% and 61% for IFX, and 80%, 71% and 49% for ADA, respectively (Fig.