P0985Impact of IBD therapies on the clinical course and relapse of autoimmune pancreatitis type 2: a multicentre cohort study

Background Autoimmune pancreatitis type 2 (AIP-2) is associated with an inflammatory bowel disease (IBD) in 15-30 % of cases. Epidemiological and histological data suggest shared pathogenic pathways. Several studies have reported that IBD treatments may improve AIP-2 outcomes. We aimed to assess the impact of IBD treatments on the clinical course of AIP-2. Methods We conducted a multicenter retrospective cohort study across 16 French and Belgian centres, including all patients with IBD who had a concomitant or subsequent diagnosis of AIP-2 according to ICDC criteria between2010 to 2025. Inclusion date corresponded to the date of AIP-2 diagnosis. Therapeutic effect of IBD therapies (conventional immunosuppressants, anti-TNF agents, and other advanced therapies) on AIP-2 was assessed through clinical response (symptoms improvement or resolution), radiological response (improvement or resolution of imaging abnormalities), and the occurrence of clinical and/or radiological relapse during follow-up. Results Ninety-six patients (48 women) were included. Mean age at IBD and AIP-2 diagnosis was 30 ± 13 and 34 ± 14 years, respectively; ulcerative colitis was the predominant IBD subtype (74%). At AIP-2 diagnosis, 52 patients (54%) were receiving IBD therapy. Clinical benefit was observed in 35/52 (67%) patients: 30/35 (86%) treated with corticosteroids, 2/4 (50%) with anti-TNF, and 3/4 (75%) with conventional immunosuppressants. Radiological benefit was observed in 22 (63%) patients treated with steroids, 2 (50%) with anti-TNF, and 3 (75%) with conventional immunosuppressants. During a median follow-up of 65 ± 43 months, 35 patients (36%) experienced AIP-2 relapse. Relapse rates at 1 and 5 years were 20% and 33.7%, respectively. In univariate analysis, AIP-2 relapse risk was significantly lower in patients receiving IBD therapy compared with untreated patients (p = 0.05). No relapse occurred after the initiation of anti-TNF therapy in biologic-naïve patients. Overall, 16 (42%) patients developed AIP-2 complications: 7 diabetes and 9 exocrine pancreatic insufficiency. Conclusion In this large multicentre cohort, clinical improvement or resolution was observed in two-third of patients receiving IBD therapy during their first AIP-2 episode. Relapse of AIP-2 appeared less frequently in patients receiving conventional immunosuppressant or advanced therapy for IBD. These therapies may be included in the treatment algorithm for AIP-2. Conflict of interest: Imberton, Louise: No conflict of interest Cremer, Anneline: No conflict of interest Kirchgesner, Julien: Lecture fees and/or consulting fees from from Abbvie, Amgen, Astrazeneca, Celltrion, Galapagos, Janssen, Lilly, MSD, Takeda, Tillots, Pfizer. Bonnet, Joelle: No conflict of interest Vieujean, Sophie: No conflict of interest Hostaux, Lorent: No conflict of interest Guillo, Lucas: No conflict of interest Fumery, Mathurin: Grant: Pfizer Personal Fees: Abbvie, Janssen, Takeda, MSD, Biogen, Amgen, Sandoz, Fresenius, Gilead, Celgene, Galapagos, Mylan, Tillots, Ferring, Pfizer, Hospira, CTMA, Boehringer, Lilly, Arena Non-financial Support: Abbvie, Janssen, Takeda, MSD, Galapagos, Ferring, Pfizer Uzzan, Mathieu: Grant: ECCO-IOIBD, Fondation pour la Recherche Medicale (FRM), SNFGE Personal Fees: Abbvie, Takeda, Celltrion, Janssen, Amgen, Alfasigma, Pfizer Hupé, Marianne: No conflict of interest Vidon, Mathias: No conflict of interest Bergereau, Eric: No conflict of interest Duveau, Nicolas: No conflict of interest Le Gall, Guillaume: No conflict of interest Nahon, Stéphane: No conflict of interest Riviere, Pauline: Personal Fees: Abbvie, Celltrion, Janssen Non-financial Support: Celltrion Maire, Frederique: No conflict of interest Rebours, Vinciane: No conflict of interest Prof. Dr. Laharie, David: Personal Fees: Board, consulting and lecture fees from Abbvie, Alfasigma, Amgen, Biocon, Celltrion, Ferring, Fresenius-Kabi, Johnson & Johnson, Lilly, MSD, Pfizer, Sandoz and Takeda