P0682One-year Dynamics of Clinical Activity During Biologics Therapy in Patients of Ulcerative Colitis

Abstract Background Longitudinal assessment of clinical activity is crucial for evaluating and predicting therapeutic outcomes in ulcerative colitis (UC) patients receiving biologics. However, the long-term trajectories of clinical activity and the optimal timing for clinical activity evaluation remains unclear. Methods This study included 2,705 UC patients from five clinical trials and collected records of 28,807 partial Mayo scores (PMS) from baseline to week 52. Latent class growth mixed model was performed to construct one-year trajectories of clinical activity. Multivariable logistic regression was conducted to investigate the association between PMS trajectories and therapeutic outcomes at the end of maintenance therapy. Spearman correlation analysis was utilized to identify the timepoints of PMS most correlated with the PMS trajectories. Results Five trajectories of clinical activity were identified in UC patients, including rapid remission (n = 590, 21.8%), delayed remission (n = 316, 11.7%), mild improvement (n = 748, 27.7%), slow improvement (n = 915, 33.8%), and relapse-fluctuation (n = 136, 5.0%, Figure 1). Endoscopic and histological remission rates exhibited a progressive decline across trajectory groups, with the highest probability in the rapid remission group and sequentially lower probabilities in the delayed remission, mild/slow improvement, and relapse-fluctuation groups (all p 0.001). Week-20 PMS demonstrated the strongest correlation with clinical activity trajectories (correlation coefficient = 0.7867, p 0.001, Figure 2), and independently predicted one-year endoscopic (aOR 0.59 0.54-0.65, p 0.001) and histological (aOR 0.61 0.53-0.70, p 0.001) remission. Conclusion UC patients receiving biologics would exhibit five distinct trajectories of clinical activity. Week 20 is a potential key timepoint for clinical activity assessment to inform long-term outcomes. References: 1. Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005;353(23):2462-2476. 2. Sandborn WJ, Feagan BG, Marano C, et al. Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2014;146(1):96-109. 3. Sands BE, Sandborn WJ, Panaccione R, et al. Ustekinumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2019;381(13):1201-1214. 4. Feagan BG, Rutgeerts P, Sands BE, et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013;369(8):699-710. 5. Sands BE, Peyrin-Biroulet L, Loftus EVJ, et al. Vedolizumab versus adalimumab for moderate-to-severe ulcerative colitis. N Engl J Med 2019;381(13):1215-1226. Conflict of interest: Dr. Tie, Yizhe: No conflict of interest Su, Fengyuan: Zhang, Jianwu: No conflict of interest Chen, Minhu: No conflict of interest Chen, Rirong: There is no conflict of interest. Li, Li: No conflict of interest Zhang, Shenghong: No conflict of interest