P0779Prevalence, clinical characterisation and therapeutic outcomes of non-fistulising perianal lesions in Crohn’s disease (ULCERS-CD): Results from the ENEIDA registry of GETECCU

Abstract Background Non-fistulising perianal lesions (NFPL) in Crohn’s disease—including skin tags, fissures, ulcers, and anorectal strictures—are poorly described. Moreover, evidence on treatment response is scarce and heterogeneous, limiting therapeutic decision-making. We aimed to characterise NFPL in a real-world nationwide cohort and to evaluate therapeutic strategies and clinical outcomes. Methods Adult CD patients with NFPL (fissures, ulcers, strictures) recorded in the prospectively maintained ENEIDA registry of GETECCU, were included. Demographics, and clinical characteristics were collected. Clinical records were additionally reviewed to obtain detailed information on NFPL features and treatments received. The frequency of NFPL within the registry population was calculated. For treatment evaluation (fissures), only patients with ≥12-week follow-up after NFPL diagnosis were analysed. Clinical response was defined as complete healing of the lesion according to physician assessment. Treatment strategies for NFPL were evaluated across therapeutic lines (first, second and third). Global therapeutic response was defined as complete healing at any therapeutic line of the same treatment. Results Among 36,661 patients with Crohn’s disease included in ENEIDA, 8,667 had perianal disease. Of these, 2,434 patients (28%, 95% CI = 28-29%) had NFPL. We included 490 patients (mean age at NFPL diagnosis: 34 years; male: 51%; Montreal location L1/L2/L3: 36%/24%/40%; behaviour B1/B2/B3: 70%/13%/17%; concomitant fistulising perianal disease: 33%). Anal fissure was the most frequent lesion (417/490; 85%), followed by anorectal strictures (53/490; 11%) and cavitating ulcers (52/490; 11%). Clinical characteristics of these patients are detailed in table 1. For treatment analysis, 417 patients with fissures and complete follow-up were evaluated (female: 51%; location L1/L2/L3: 39%/22%/39%; behaviour B1/B2/B3: 72%/16%/16%; concomitant fistulising perianal disease: 31%). First-line therapy induced clinical healing in 66% (224/341; 95% CI 60–71%): vasodilators 63%, botulinum toxin 60%, surgery 95%, biologics 54%. Global therapeutic response was: vasodilators 80%, surgery 78%, botulinum toxin 76%, biologics 77%. Overall, 70% (291/417) of patients achieved clinical healing of the fissure. Conclusion Non-fistulising perianal lesions are common in Crohn’s disease and respond favourably to standard therapies. In a real-world nationwide cohort, anal fissures predominated, and two-thirds of patients responded to first-line therapy, with overall 70% of patients achieving complete healing, supporting that these lesions should be recognised, diagnosed early, and treated following structured therapeutic pathways. Reference: *M. Chaparro and JP. Gisbert share senior authorship. Conflict of interest: Dr. Casanova, María José: María José Casanova, has received education funding from Pfizer, Takeda, Janssen, MSD, Dr. Falk, Shire, Ferring, Galápagos and Abbvie, and research funding from Lilly. De Francisco Garcia, Ruth Maria: No conflict of interest López Ramos, Carmen: No conflict of interest Hernandez Camba, Alejandro: I have served as a speaker or has received research or education funding or advisory fees from Lilly, Takeda, J and J, FAES Pharma, Falk, Abbvie, Adacyte Therapeutics, Tyllots, Ferring, Kern Pharma, Alfasigma and Chiesi. Gargayo-Puyuelo, Carla: No conflict of interest Castro Senosiain, Beatriz: No conflict of interest Mesonero Gismero, Francisco: I ve served as a speaker for and received consulting fees from MSD, AbbVie, Takeda, Janssen, Pfizer, Ferring Pharmaceuticals, Kern Pharma, Dr. Falk Pharma, Galapagos, Lilly, Chiesi Farmaceutici, and Faes Farma. Pagola, Leire: No conflict of interest Artero Cruañas, Arnau: No conflicts. Giordano, Antonio: Antonio Giordano received educational funds from Johnson & Johnson, Abbvie, Alfasigma, Ferring, Kern Pharma, and Dr. Falk. Ponferrada Diaz, Angel: financial support for travelling and educational activities from Johnsson and Johnsson, AbbVie, Takeda, Alfasigma, Lilly, Faes Farma and Ferring. Madero Velázquez, Lucía: None Robledo-Andrés, Pilar: Pilar Robledo have participated in scientific meetings, conferences, and consultancy activities for Lilly, Janssen, AbbVie, Takeda, Pfizer, MSD, Faes, Dr Falk, Galápagos, and Tillotts Pharma. Regueiro, Cristina: No conflict of interest Sampedro Gonzalez, Manuela: No conflict of interest Alvarado Jara, Rubén: No conflict of interest Ceballos Santos, Daniel: No conflict of interest Betoré Glaría, Elena: No conflict of interest Marquès-Camí, Miquel: No conflicts Varela Trastoy, Pilar: No conflict of interest Barreiro-de Acosta, Manuel: MBA has been speaker, consultant and advisory member for or has received research funding from MSD, AbbVie, Janssen, Kern Pharma, Celltrion, Takeda, Alphasigma, Lilly, Pfizer, Sandoz, Biocon, Abivax, Fresenius, Faes Farma, Ferring, Tillots, Chiesi, Adacyte, Diasorin, Oncostellae and SunRock. Robles de la Osa, Daniel: No conflict of interest Salmoral Luque, Rosario: Have received education support from Alfasigma, Janssen Teller, Marta: Marta Teller have received support for travelling ans educational activities from Abbvie, Alfasigma, faesfarma, falk, fferring, Johnson&Johson, Lilly, Takeda, Tillots, and has served as a speaker for Alfasigma, Norgine, Schwabe. Rubín De Célix, Cristina: Cristina Rubín de Célix has received education funding from Ferring, Tillotts Pharma, AbbVie, Sandoz, Alfasigma, Lilly, Norgine, MSD, Pfizer, Takeda, and Janssen Almela, Pedro: Tillotts Pharma, AbbVie, Sandoz, Alfasigma, Lilly, Norgine, MSD, Pfizer, Font-Ordeig, Guillem: Takeda, and Janssen. CR has served has a speaker for Takeda. Bujanda, Luis: No conflict of interest Orenga-Sánchez, Carmen: No conflict of interest Oliveras-Font, Berta: No conflict of interest Gilabert Alvarez, Pau: No conflict of interest Mena Sánchez, Raquel: No conflict of interest Delgado Guillena, Pedro Genaro: No conflict of interest Maroto Arce, Nuria: No conflict of interest Perez Martinez, Isabel: “No conflicts” Garcia Alonso, Francisco Javier: I have acted as a speaker for Abbvie, Lilly and Johnson and Johnson Roig Ramos, Cristina: CR has received support for conference attendance and education funding from Kern Pharma, Ferring, Alfasigma, Faes Farma, Pfizer and Takeda. Domènech Moral, Eugeni: Personal Fees: I have served as a speaker, or has received research or education funding or advisory fees from AbbVie, Adacyte Therapeutics, Biogen, Celltrion, Gilead, Janssen, Kern Pharma, MSD, Pfizer, Roche, Samsung, Takeda, Tillots. Other: I have served as a speaker, or has received research or education funding or advisory fees from AbbVie, Adacyte Therapeutics, Alfasigma/Galapagos Biogen, Celltrion, Ferring, Gilead, GoodGut, Imidomics, Janssen, Kern Pharma, Lilly, MSD, Pfizer, Roche, Takeda, Tillots. Chaparro, María: Grants: Pfizer, Janssen, Biogen, Abbvie, Lilly Personal Fees: Pfizer, Faes, Lilly, Abbvie, Janssen Gisbert, Javier: Grant: MSD, Abbvie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene/Bristol Myers, Gilead/Galapagos/Alfasigma, Lilly, Sanofi, STADA, Teva, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Norgine, Italfarmaco, and Vifor Pharma. Personal Fees: MSD, Abbvie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene/Bristol Myers, Gilead/Galapagos/Alfasigma, Lilly, Sanofi, STADA, Teva, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Norgine, Italfarmaco, and Vifor Pharma. Other: MSD, Abbvie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene/Bristol Myers, Gilead/Galapagos/Alfasigma, Lilly, Sa