P0747Intestinal ultrasound remission rates following biologic initiation in Crohn’s Disease: a real-World rates at 14, 26, and 52 weeks

Abstract Background Intestinal ultrasound (IUS) is increasingly used to monitor Crohn’s disease (CD) activity and therapeutic response. We evaluated real-world sonographic transmural healing (TMH) rates following initiation of biologic therapy at week 14, 26 and 52. Methods Retrospective cohort of adult CD patients initiating a new biological (Adalimumab/Infliximab (anti-TNF), Vedolizumab (VDZ) or Ustekinumab (UST)). IUS was performed at baseline and at weeks 14, 26 and 52. TMH was defined as bowel wall thickness (BWT) ≤3 mm across evaluated segments. Changes within groups were tested by chi-square; between-group differences are reported as remission rate differences (percentage points). Results A total of 197 patients (median age 33 19-82; 49% male) with ileal (63%), ileocolonic (33%) or colonic (4%) disease who initiated a new line of biological treatment were included. At baseline, abnormal IUS was present in 79% (anti-TNF), 86% (VDZ), and 89%(UST). At week 14, TMH was achieved in 36.7% (anti-TNF), 37.7% (VDZ), and 36.8% (UST). McNemar’s test showed a statistically significant improvement in the proportion of TMH for VDZ (p = 0.011), with a trend toward improvement in the anti-TNF (p = 0.096) and UST (p = 0.063) groups. At week 26, TMH rates increased to 58.3% (anti-TNF), 48.1% (VDZ), and 45.8% (UST). A significant change from baseline was observed in the anti-TNF (p 0.001) and VDZ (p = 0.01) groups, but not in the UST group (p = 0.18). By week 52, TMH was observed in 55.3% (anti-TNF), 45.1% (VDZ), and 31.4% (UST). A significant improvement from baseline was noticed in the anti-TNF (p 0.001) and VDZ (p = 0.003) groups, and a non-significant trend in the UST group (p = 0.07) (Figure 1). We also observed a progressive reduction in BWT across all treatment groups over time. The anti-TNF group showed the most pronounced and consistent decrease in MAX BWT, whereas reductions in the VDZ and UST groups were more modest and plateaued after week 26 (Figure 2). Conclusion Significant sonographic remission was observed following biologic initiation, with anti-TNF agents achieving the most rapid response and vedolizumab demonstrating the highest sustained remission at one year. Ustekinumab showed slower, numerically lower response rates. IUS proved effective for tracking disease evolution and guiding biologic management. Conflict of interest: Dr. Abend, Alon: non Ukashi, Offir: NA Shani, Uria: No conflict of interest Kopylov, Uri: Grant: Takeda, Janssen,Abbvie, Medtronic, Ely Lilly Other: Takeda, Janssen,Ely Lilly, Roche, Celtrion, Abbvie, Medtronic, CTS, Pfizer, BMS- speaker and advisory fees Carter, Dan: Personal Fees: speakers fees from Takeda, Janssen, Abbvie, Taro and Lapidot Tarp and consultancy fees from Takeda Taro and Lapidot Ben-Horin, Shomron: Grant: Abbvie, Takeda, Janssen, Celltrion, Pfizer, Medtronic, Galmed, OutSense Personal Fees: Advisory board and/or consulting and/or Speaker fees from Abbvie, Takeda, Janssen, Celltrion, Pfizer, GSK, Ferring, Novartis, Roche, Gilead, NeoPharm, EviNature, Galmed, Medial Earlysign, BMS, Pfizer, Falk, Medtronic and Eli Lilly. Options/stocks in Predicta Med, Evinature, Galmed, Alma Therpeautics. Albshesh, Ahmad: received speaking and lecturing fees from Takeda, Janssen and abbvie