P0780Effect of JAK inhibitors on extra-intestinal manifestations and concurrent immune-mediated inflammatory diseases in patients with inflammatory bowel disease

Abstract IMPACT-IBD studygroup: Ioannis Koutroubaki (Department of Gastroenterology Venizelio General Hospital Heraklion Greece) Ioannis Psaroudakis (Department of Gastroenterology Venizelio General Hospital Heraklion Greece) Background Immune-mediated inflammatory diseases (IMIDs) and extra-intestinal manifestations (EIMs) are frequent in IBD and contribute ­substantially to morbidity. JAK inhibitors have demonstrated efficacy across several rheumatological IMIDs and emerging evidence suggests potential benefit in dermatological IMIDs such as atopic dermatitis. Additional real-world evidence is needed to guide their optimal positioning within IBD management. Methods This multicentric retrospective cohort included adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) who initiated a JAK inhibitor (tofacitinib, upadacitinib or filgotinib) for IBD and had at least one EIM or IMID. IBD and EIM/IMID activity were assessed after induction (week 6–14), at month 6, and at month 12 using physician’s global assessment. IBD outcomes included clinical, biochemical and endoscopic remission. Treatment discontinuation due to primary non-response (PNR), loss of response (LOR) or surgery was classified as non-remission. The primary endpoint was EIM/IMID response while secondary endpoints included steroid-free IBD remission and new-onset of EIMs/IMIDs. Results In total 214 patients were included (Table 1) with a median follow-up of 10 months (IQR 5-12). Steroid-free clinical remission was achieved in 38% post-induction and increased to 54% at 12 months (Figure 1). At baseline, axial and peripheral SpA were active in 72% and 80% of cases respectively; response rates reached 75% and 80% post-induction and remained 57% and 71% at 12 months. Psoriasis and hidradenitis suppurativa were active at baseline in 42% and 89% of patients, with response rates of 62% and 67% post-induction and decreasing to 40% and 50% at 12 months. Among 170 patients with available follow-up, seven (4.1%) developed new-onset EIMs/IMIDs, including peripheral SpA (n = 3), oral CD manifestations (n = 2) and one case each of pyoderma gangrenosum, axial SpA, primary sclerosing cholangitis and autoimmune hepatitis. Treatment was discontinued in 62 patients (29%) after a median of 5 months (IQR 2–10), mainly due to active IBD (PNR: n = 14 (23%) or LOR: n = 23 (37%)). Discontinuation due to worsening or new onset of EIMs/IMIDs occurred in 11 (18%) and 1 (2%) patient respectively. Conclusion JAK inhibitors demonstrated effectiveness for IBD activity and associated EIMs/IMIDs, with particularly robust responses in peripheral SpA and more variable outcomes in dermatological manifestations. New-onset EIMs/IMIDs were uncommon. Conflict of interest: Dr. Truyens, Marie: No conflict of interest Tolstoy, Xenia: No conflict of interest Calabrese, Giulio: Travel grant by Johnson and Johnson Speaker fee by Celltrion Balestrieri, Paola: Advisory board for Alfasigma- Janssen- Abbvie- Takeda- Eli Lilly Argyriou, Konstantinos: No conflict of interest Blesl, Andreas: No conflict of interest Pouillon, Lieven: Lieven Pouillon received advisory board fees from AbbVie, Alphasigma, Celltrion, Galápagos, Janssen-Cilag, Sandoz and Takeda consultancy fees from Ipsos NV and Ismar Healthcare funded by Viatris presentation fees from AbbVie, Alphasigma, Celltrion, Eli Lilly, Ferring, Galápagos and Pfizer and personal fees (congress support) from AbbVie, EG, Ferring, Galápagos, Janssen-Cilag, Norgine and Takeda. Shakweh, Eathar: Travel grants from Lilly and Falk, support to attend meetings from AbbVie and Takeda, and speaker fees from Takeda. Filip, Rafal: No conflict of interest Drygiannakis, Ioannis: No conflict of interest Todeschini, Alessia: The author has served as a consultant and/or received lecture fees from Abbvie, Alfasigma, Celltrion, Johnson & Johnson, Ely Lilly, Ferring, Lion Health,Takeda. Mocci, Giammarco: NO CONFLICTS OF INTEREST Pastras, Pl: No conflict of interest Ribaldone, Davide Giuseppe: Davide Giuseppe Ribaldone declares the following paid consultancies, lecture fees for the past two years: Johnson & Johnson, Takeda, Celltrion, Alfasigma, Pfizer, Eli Lilly, Abbvie, Sandoz Jauregui-Amezaga, Aranzazu: I declare that I have no personal financial conflicts of interest related to my scientific activities. Any research funding received from Takeda, Johnson & Johnson, and AbbVie has been allocated to the research group to which I belong and has been used exclusively to support institutional or group-based research initiatives, with no personal financial benefit. Moraleja-Yudego, Irene: Non Vieujean, Sophie: No conflict of interest Karmiris, Konstantinos: Personal Fees: Speaker fees from Abbvie, BMS, Eli-Lilly, Genesis, Innovis, Johnson & Johnson, Pfizer and consultancy or advisory board member fees from Abbvie, BMS, Faran, Ferring, Genesis, Johnson & Johnson, Pfizer, Roche and Takeda Taelman, Thibault: None Kani, Haluk Tarik: Haluk Tarik Kani has been speaker or advisor for Abbvie, Janssen and Takeda. García, María José: MJ García has received financial support for travelling and educational activities from Janssen, Pfizer, Abbvie, Takeda and Ferring. Cremer, Anneline: Consulting fee from AbbVie, Takeda, Alfasigma, Johnson & Johnson. Speakers fee from AbbVie, Takeda, Alfasigma, Johnson & Johnson, Celltrion, Galapagos, Eli Lilly, Pfizer Savarino, Edoardo Vincenzo: Personal Fees: Takeda, Abbvie, MSD, Janssen, Sofar Felice, Carla: Advisory board for AbbVie, MSD, J & J. Gordon, Hannah: Personal Fees: Speaker fees : Janssen (J & J), Ferring, Takeda, AbbVie, Lilly Consultancy fees: AbbVie, Galapagos, Janssen (J & J), Takeda, Lilly Vladimirova, Nora: Grants from MSD, Novartis (paid to the employer) Attauabi, Mohamed: Research grants from Novo Nordisk Fonden and Lundbeck Foundation. Personal fees from Eli Lilly, Celltrion, and Lundcbeck foundation, outside the submitted work. Barreiro-de Acosta, Manuel: MBA has been speaker, consultant and advisory member for or has received research funding from MSD, AbbVie, Janssen, Kern Pharma, Celltrion, Takeda, Alphasigma, Lilly, Pfizer, Sandoz, Biocon, Abivax, Fresenius, Faes Farma, Ferring, Tillots, Chiesi, Adacyte, Diasorin, Oncostellae and SunRock. Michalopoulos, George: speaker fees TAKEDA, ABBVIE, MSD, GALENICA, ENORASIS, AMGEM PFEIZER Innocenti, Tommaso: Speaker fees from Aurora Biofarma, and Ferring. Travel grants from Abbvie, Alfasigma, Celltrion, Eli Lilly, Ferring, Malesci, Pfizer. Holvoet, Tom: Speaker fees and/or researchs grant from abbvie, takeda, alfasigma, viatris, celltrion, J&J Estevinho, Maria Manuela: MME reports honoraria for lectures from J & J and Abbvie. Karakan, Tarkan: None Vrakas, Spyridon: None Kapizioni, Christina: Travel Grants from Abbvie, Takeda Noor, Nurulamin: Grants: Celltrion, Dr Falk, Pfizer, Pharmacosmos, Tillotts. Personal Fees: AbbVie, BMS, Celltrion, Ferring, J&J, Lilly, Pfizer, Pharmacosmos, Takeda. Advisory board fees: AbbVie, BMS, Pfizer, Takeda. Dağcı, Gizem: No conflict of interest Nardone, Olga Maria: Advisory board fees from Eli Lilly, Nestlè, Janssen Speaker fees from AbbVie, Janssen, Eli Lilly, Ferring, Alfa Sigma, Recordati, Noòs, and Pfizer Hedin, Charlotte Rose: No conflict of interest Lobatón Ortega, Triana: Grant: Abbvie, Ferring, Viatris, MSD, EG, Mundipharma, Biogen, Janssen, Pfizer, Takeda, Galapagos, Afasigma and Sandoz. Personal Fees: Speaker fees from MSD, Abbvie, Janssen, Amgen, Fresenius Kabi, Galapagos, Viatris, Ferring, Celltrion, Alfasigma, Lilly and Takeda. Consulta