P1168Assessing the impact of a combined Inflammatory Bowel Disease-Rheumatology Clinic: A four-year retrospective service evaluation

Abstract Background Rheumatological manifestations are common in patients with Inflammatory Bowel Disease (IBD) and contribute substantially to morbidity and impaired quality of life.1,2 These patients require multidisciplinary care, traditionally delivered through separate consultations, with inter-speciality communication occurring in the patient’s absence. To provide a more patient-centred model, we established a combined Gastroenterology-Rheumatology Clinic (GRC), where patients are jointly reviewed by both specialities and management decisions are made with real-time patient input. We report four-year data describing the GRC cohort and service impact. Methods We performed a retrospective review of electronic records for all patients seen in the GRC between June 2021 and September 2025. An anonymous patient satisfaction survey was distributed to clinic attendees in June and September 2025. Results Across 17 clinics, 63 patients were reviewed over 130 appointments; 43% attended more than once (median attendance 1; range, 1-10). The majority (59, 94%) had IBD: Crohn’s disease 42 (71%), ulcerative colitis 15 (25%) and IBD-unclassified 2 (3%). Among patients with Crohn’s disease, 19 (45%) had stricturing or penetrating behaviour (B2/B3) and 21 (50%) had ileocolonic disease (L3). Of those with ulcerative colitis, 6 (40%) had extensive colitis (E3). Prior intestinal resection had been performed in 26 patients with IBD (44%). Inflammatory arthritis was present in 51 patients (81%): isolated axial spondyloarthritis 20 (39%), isolated peripheral arthritis 21 (41%), and combined axial and peripheral disease 10 (20%). Among those with axial involvement, mean baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 6.2 (SD 2.5; n = 21), indicating high disease activity. Other rheumatological diagnoses included osteoarthritis (6, 10%), rheumatoid arthritis (1, 2%), and polymyalgia rheumatica (2, 3%). At first GRC review, 52 patients (83%) had received at least one advanced therapy. During follow-up, 40 patients (63%) had medication changes, and 47 (75%) had other management actions (e.g. investigations or referrals). Overall, 100 appointments (77%) across 60 patients (95%) resulted in a treatment change or other clinical intervention. Among 19 survey respondents, the median satisfaction score was 50 out of 50 (IQR 49–50). Conclusion The GRC cohort was clinically complex, with a high prevalence of advanced disease phenotypes, prior advanced therapy use, and previous surgery. Treatment changes and other clinical interventions were made for the majority of patients and across most appointments. Patient-reported experience was highly positive. Collectively, these findings demonstrate the value of this integrated, patient-centred model of care. References: 1. Khrom M, Long M, Dube S, et al. Comprehensive Association Analyses of Extraintestinal Manifestations in Inflammatory Bowel Disease. Gastroenterology. 2024;167(2):315-32. 2. Gordon H, Burisch J, Ellul P, et al. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis. 2024;18(1):1-37. Conflict of interest: Dr. Mulligan, Robert: Robert J. Mulligan acknowledges research support from Open Targets, Wellcome Trust, European Bioinformatics Institute (EMBL-EBI), Genentech, GlaxoSmithKline, Merck Sharp and Dohme, Pfizer, and Sanofi and support for educational meeting attendance from Ferring. Stanway, James A.: No conflict of interest Speight, Ally: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: AbbVie, Lilly, Dr Falk Pharma Janssen Support for attending meetings and/or travel: AbbVie, Dr Falk Pharma Janssen, Tillott’s pharmaceuticals Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: BSG IBD Section Committee (unpaid) Pathan, Ejaz M I: No conflict of interest Hussain, Amaani B: ABH is supported by the Medical Research Council through a clinical research training fellowship and acknowledges support from the NIHR Newcastle Biomedical Research Centre. ABH has received conference attendance support from Almirall. Beck, Lauren: No conflict of interest Thompson, Ben: No conflict of interest Lamb, Christopher Andrew: Grant: In the last 5 years I have undertaken research supported by grants from the following: Genentech, Janssen, Takeda, AbbVie, Eli Lilly, Pfizer, Roche, UCB Biopharma, Sanofi Aventis, Biogen IDEC, Orion OYJ and AstraZeneca. Personal Fees: In the last 5 years I have received honoraria for speaking at educational events from Takeda, Janssen, Dr Falk, Ferring and Nordic pharma. Other: The following companies were corporate sponsors of an educational event, IBD Newcastle 2023, I convened at Newcastle University on 29th November 2023 Amgen, Celltrion Healthcare, Janssen, Tillotts Pharma, Pharmacosmos, Dr Falk Pharma, Galapagos, Ferring, AbbVie, Takeda, Eli Lilly and Bristol Myers Squibb.