4CPS-054 Abstract withdrawn

Background and Importance Moderate-to-severe ulcerative colitis (UC) can be treated with several therapeutic alternatives. Recently, new drugs have been evaluated in this disease. Aim and Objectives To develop a network meta-analysis (NMA) to compare the efficacy of treatments formoderate-to-severe UC. Material and Methods Scientific publications indexed in Pubmed were used. Inclusion criteria: pivotal randomised clinical trials (RCT) including recent drugs (filgotinib, ozanimod, tofacitinib,upadacitinib, ustekinumab and vedolizumab) in moderate-to-severe UC. Exclusion criteria: RCT without a comparator common (placebo). Relevant clinical baseline characteristics of populations were considered: age, gender, disease duration and prior biologic use. Efficacy endpoint was clinical remission according to Full Mayo Score. Induction (week 6, 8 or 10) and maintenance (week 52, 48 or 60) results were analysed. R v4.2.3 statistical software was used to perform the NMA. Odds ratio(OR) were calculated by bayesian methods and fixed effect model were assessed. Results Eleven RCT were selected Age was similar in all populations. Female gender reached percentages of approximately 40% of patients, except for fingolimod 200mg/day(49.8%) and tofacitinib 5mg/12 hours maintenance (46.1%). Disease duration was generally between 6–7 years, being more durable in patients receiving upadacitinib45mg (induction) and 15–30mg (maintenance)/day (8.6 years), and vedolizumab300mg in weeks 0–2-6 and then every 8 weeks (8.3 years). Pre-treatment with biological agents was around 51% of populations in most RCTs, except for vedolizumab300mg in weeks 0–2-6 and then every 8 weeks (42.6%), vedolizumab 108mg/biweekly subcutaneous in maintenance (39.2%) and ozanimod 1mg/day (30.2%). In induction results, upadacitinib 45mg/day (OR 9.43;95%CI 5.38–16.54) achieved the greatest magnitude of effect and only ozanimod 1mg/day (OR 5.15;95%CI 2.76–9.61) showed similar efficacy. In maintenance results, upadacitinib 30mg/day (OR 7.87;95%CI 4.38–14.13) reached the best effect magnitude. Regarding upadacitinib 30mg/day, no statistically significant differences were found with upadacitinib 15mg/day (OR5.25;95%CI 2.91–9.48), filgotinib 200mg/day (OR 4.68;95%CI 2.35–9.33) and vedolizumab 108mg/biweekly subcutaneous (OR 4.23;95%CI 2.14–8.39). Conclusion and Relevance This NMA provided a review of efficacy of recent therapies for moderate-to-severe UC according to clinical remission. In induction, upadacitinib 45 mg/day and ozanimod1mg/day were the most effective schemes. In maintenance, similar benefit was observed with the following regimens: vedolizumab 108mg/biweekly subcutaneous, filgotinib 200mg/day and upadacitinib 15 mg-30 mg/day. References and/or Acknowledgements Conflict of Interest No conflict of interest.