P0350ECCO Global Grant 2025: determining transethnic, transcontinental differences in perianal fistulising Crohn’s disease

Abstract Background At ECCO 2025, a global grant was awarded to support transcontinental collaborative research in perianal fistulising Crohn’s disease (PFCD). PFCD is under-represented in inflammatory bowel disease (IBD) research. This work aims to characterise transethnic and transcontinental similarities and differences in PFCD phenotype, diagnosis, trajectory, treatment approach and molecular profile across the globe, leveraging collaborations with countries in Asia, South America and Africa. Additionally, it aims to facilitate infrastructural developments at collaborating sites to strengthen future IBD research and education, using PFCD as a vehicle. Methods The objectives of the grant will be delivered over 6 work packages (WP): 1. Systematic review and meta-analysis exploring differences and similarities in PFCD dependent on ethnicity 2. Clinical phenotyping of participants with established PFCD – retrospective data collection (n = 700) 3. Clinical phenotyping of a PFCD inception cohort, including data on diagnostic delay, quality of life assessment and radiology (n = 300) 4. Characterising transethnic transcriptomic signatures in PFCD in a treatment-naive inception cohort (blood and fistula tissue bulk RNA sequencing) 5. Characterising microbiome-metabolome interactions in PFCD and transcontinental differences (faecal 16S RNA sequencing and metabolomics, with bioinformatics-led pathway analysis) 6. Identifying region-specific areas for improvement in PFCD care, with local education initiatives Results Ethical approvals are in place at participating sites. In most regions, this was an iterative process over months, requiring multiple reviews by local hospital and governmental boards. We designed a data collection tool, harmonised with the grant objectives and regional research questions. To support the translational aims of the grant, we designed a laboratory manual, and an accompanying instructional video on biosampling procedures. Progress is summarised in Table 1. Conclusion This work will address each item of ECCO’s 5-year REACH strategy. It will assess time to diagnosis, equitable access and sustainable healthcare, probe pathogenic drivers and address the holistic impact of PFCD in different parts of the world. Key lessons learned: 1. Global translational work presents logistical and regulatory challenges – some centres do not permit the international transfer of tissue across borders (and this can change with an evolving political landscape) 2. Pragmatism over perfection is essential, when delivering multicentre projects in resource limited settings Conflict of interest: Dr. Shakweh, Eathar: Received travel grants from Lilly and Falk, support to attend meetings from AbbVie and Takeda and speaker fees from Takeda. Anand, Easan: No conflict of interest Pelly, Theo: No conflict of interest Hanna, Luke: None Joshi, Shivani: No conflict of interest Sundramoorthi, Rohan: No conflict of interest Zacharias, Neha: No conflict of interest Marikanty, Adarsh: No conflict of interest Osorio, Laura: No conflict of interest Toruner, Murat: No conflict of interest Salem, Osama Ebada: No conflict of interest Juliao Baños, Fabián: No conflict of interest Sharma, Vishal: No conflict of interest Sebastian, Shaji: Grant: Takeda, Tillots pharma, Biogen, Pfizer, Abbvie, Johnson & Johnson, Olympus -Odin Vision Personal Fees: Tillots, Johnson & Johnson, Olympus Odin Vision, AbbVie, Takeda, Merck, Pharmacosmos, Amgen, Eli Lilly, BMS, Odin Vision Non-financial Support: Tillots, Takeda, AbbVie, Celltrion, Johnson & Johnson, Eli Lilly, Alphasigma, Ferring Pharma Powell, Nick: Grant: Takeda, BMS, Pfizer, Astra-Zeneca Personal Fees: Abbvie, Abivax, Allergan, Astra-Zeneca, Bristol-Myers Squibb, Celgene, Celltrion, Dr Falk Pharma UK Ltd, Ferring, Galapagos, GSK, Janssen, MSD, Roche, Pfizer, Sobi, Takeda, Tillotts Williams, Horace: Fees from Pfizer, Takeda, Tillotts Pharma. Tozer, Philip: Personal Fees: Takeda - speakers fees, member of Inspire, and advisory boards Ferring - speakers fees Falk - speakers fees Tillott’s - speakers fees J & J - speakers fees Abbvie - speakers fees Hart, Ailsa: Grant: Takeda Personal Fees: Abbvie, Amgen, Arena, AZ, Falk, Celltrion, Eli Lilly, Ferring, Genentech/ Roche, GSK, Pfizer, Takeda, Napp, Pharmacosmos, Janssen (J & J), Bristol-Myers Squibb, Gilead, Galapagos, Alfasigma