P1016Impact of Multiple Sclerosis on the course of Inflammatory Bowel Disease: The MULTIPLEII case-control study from the Young Group of GETECCU

Abstract Background Both multiple sclerosis (MS) and inflammatory bowel disease (IBD) are chronic immune-mediated disorders and an association between them is well described. However, data on the impact of MS on IBD course remain scarce. The aim of this study was to compare IBD phenotype and therapeutic requirements between patients with concomitant MS-IBD and those with IBD alone. Methods A retrospective multicenter Spanish case-control study was conducted. Cases were patients with concomitant MS and IBD (MS-IBD), and controls were patients with IBD without MS, matched 1:4 by sex, type of IBD, age at IBD diagnosis, and disease duration. Demographic, clinical, therapeutic, and surgical variables were analysed. The use of any biologic or selective immunomodulator for the treatment of IBD was defined as advanced therapy. Results A total of 365 patients were included: 73 MS-IBD (48 were diagnosed with MS before IBD) and 292 IBD controls. Baseline characteristics and IBD phenotype were similar between groups (Table 1). A positive family history of IBD was significantly more common in MS-IBD than in controls (15% vs 7.2%; p = 0.03). The proportion of patients ever exposed to an advanced therapy was comparable between MS-IBD and controls (52% vs 55%; p = 0.67). After stratifying by IBD type, advanced therapy use remained similar between groups in both Crohn’s disease (CD) (71% in cases vs 73% in controls; p = 0.82) and ulcerative colitis (UC) (32% vs 36%; p = 0.65). The number of advanced therapies received did not differ between MS-IBD patients and controls (median 1 1–2 in both groups; p = 0.12). Among patients diagnosed with MS before IBD onset, no differences were observed regarding time to first advanced therapy between groups (median 29 months 5-99 in MS-IBD vs 17 months 4-58 in controls; p = 0.28). In relation to the different treatments used, conventional immunosuppressants and anti-TNF agents were prescribed less frequently in MS-IBD (42% vs 56%; p = 0.035 and 11% vs 52%; p 0.001), while vedolizumab (18% vs 7.6%; p = 0.008) and S1P receptor modulators (5.6% vs 0%; p = 0.001) were more commonly used. Surgical requirements were similar across groups. Among CD patients, intestinal surgery was required in 26% of cases vs 25% of controls (p = 0.95). In UC, surgical rates were also comparable (5.9% vs 0.7%; p = 0.25). Conclusion MS-IBD patients showed a similar IBD phenotype to IBD controls, with a higher frequency of family history of IBD. Despite some differences in the type of treatment used, MS did not affect the need for advanced therapy or surgical requirements, suggesting that MS may not modify the natural course of IBD. Conflict of interest: Ms. Roig Ramos, Cristina: CR has received support for conference attendance and education funding from Kern Pharma, Ferring, Alfasigma, Faes Farma, Pfizer and Takeda. Calafat Sard, Margalida: Personal Fees: Advisory fees for Gilead Other: I have served as a speaker, or has received research or education funding for Takeda, Janssen, Faes Farma, Falk Pharma, Kern, Pfizer and MSD. Carballo-Folgoso, Lorena: No conflicts of interest to declare. Ruiz-Rodríguez, Jorge: No conflicts Calvo Moya, Marta Isabel: I have participated in presentations / advisory boards / research supported by: AbbVie, Takeda, Johnson & Johnson, Pfizer, Lilly, MSD, Chiesi, Dr Falk Pharma, Shire Pharmaceuticals, FAES, FERRING, Tillotts Pharma, Galapagos and Alfasigma Teller, Marta: No conflicts Fernandez Clotet, Agnes: None Latras Cortés, Irene: I have no conflicts of interest to disclose Zabalza San Martín, Lucía: No conflict of interest Olmedo Moreno, Cristina: I declare to have received support for educational meetings from Abbvie, Takeda, Sandoz, Janssen and Alfasigma. Rivas, Coral: No conflict of interest Alguacil Cuellar, Marta: No conflict of interest Elorza, Ainara: No conflict of interest 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, 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. Romero Martinez, Manuel: * Honorary fees from Abbvie * Financial support and inscriptions from Ferring, Abbvie, Lilly, Casen Recordati, Sandoz Castro Poceiro, Jesus: J. Castro-Poceiro has served as a speaker or received funding for training from Ferring, Tillots, Abbvie, Pfizer, Galapagos, Lilly, Takeda, Kern and Chiesi. Brunet, Eduard: I have served as a speaker and consultant for Janssen and Chiesi, Kern, Takeda and Alfasigma. Caravaca, Celia: No conflicts Bastón Rey, Iria: Personal Fees: Iria Bastón Rey has received financial support for travelling and educational activities from or has served as an advisory board member for Abbvie, Johnson&Johnson, Takeda, Pfizer, Alfasigma, Ferring, Faes Farma and Otsuka Pharmaceutical and Adacyte. Piñero, Gisela Soledad: GP has served as a speaker or has received education funding or advisory fees from Adacyte, AbbVie, Kern Pharma, Ferring, Alfasigma. Ponferrada Diaz, Angel: financial support for travelling and educational activities from Johnsson and Johnsson, AbbVie, Takeda, Alfasigma, Lilly, Faes Farma and Ferring. Orenga, Carmen: No conflict of interest Carrillo Ramos, Maria Jesus: María Jesús Carrillo Ramos has served as a speaker for Takeda and Alfasigma. Gallach Montero, Marta: No conflict of interest Tejido Sandoval, Coral: Has received support for congress and conference attendance from Abbvie, Ferring, Johnson&Johnson, Pfizer, Takeda, Tillots Pharma, Dr Falk Pharma and FAES. Has received speaker fees from Johnson&Johnson. Madero Velázquez, Lucía: None Olmedo-martín, Raúl: Dr. Raúl Olmedo-Martín has served as a speaker and consultant for Janssen, Abvvie, Kern, Takeda, Lilly, Otsuka, Ferring and Alfasigma Crespo Catalá, Ana: No conflict of interest Alonso, Inmaculada: No conflicts Garcia De La Filia Molina, Irene: I have no conflicts of interest Salmón, Pablo: I have no conflict of interest. Giordano, Antonio: Antonio Giordano received educational funds from Johnson&Johnson, Abbvie, Alfasigma, Ferring, Kern Pharma, and Dr. Falk. Rodriguez Moranta, Francisco: No conflict of interest Zabana, Yamile: Personal Fees: AbbVie, Adacyte Therapeutics, Alfa-Sigma, Amgen, Boehringer Ingelheim, Dr Falk Pharma, FAES Pharma, Fresenius Kabi, Ferring, Galapagos, Janssen-J&J, Kern Pharma, Lilly, MSD, Pfizer, Sanofi, Sandoz, Takeda, Tillots Pharma Non-financial Support: Shire, Otsuka, Almirall Garcia Planella, Esther: No conflict of interest