P0461Bowel Urgency in Adults and Pediatric Patients with Ulcerative Colitis: Insights from the National Registry CREdIT

Abstract Background Bowel urgency (BU) is increasingly recognized as a significant and troublesome symptom in patients with inflammatory bowel disease (IBD), with negative impact on quality of life (QoL). The Urgency Numeric Rating Scale (UNRS) has been developed to assess the severity of BU and is now implemented in clinical practice. The CREdIT Registry is a nationwide database of IBD patients on advanced therapy in the Czech Republic, active since March 2016. Methods This study aimed to identify determinants of bowel urgency in both adult and pediatric cohorts of ulcerative colitis (UC) patients from the CREdiT Registry. The cohort included 3386 adults and 250 pediatric patients. Data were collected at each clinical visit of patients in whom BU was measured on UNRS within 24 hours prior to the visit between February and September 2025. An ordinal mixed-effects regression model with a logit link was used. Univariable models were used for each candidate predictor, with variables advanced to the multivariable model based on statistical significance, data completeness, clinical relevance, and to avoid multicollinearity. Results Among adult and pediatric patients, 55.8% (n = 1878, 5393 observations) and 63.2% (n = 158, 490 observations) had UNRS 1, respectively. Moderate to severe bowel urgency (UNRS 3) was present at least once in 24.6% of adults and 27. 8% of pediatric patients. Despite being in remission, moderate to severe urgency was observed at least once during the study period in 5.7% of adults and 4.8% of pediatric patients. Multivariable analysis revealed that the Partial Mayo (pMayo) score was the strongest and most significant predictor of bowel urgency in adults (OR 2.96 2.77–3.16, p 0.001), with the effect remaining robust after adjustment for disease extent, gender, and treatment duration. In the pediatric cohort, the PUCAI score was the only significant predictor of BU (OR 1.29 1.23–1.36, p 0.001). Conclusion Mild bowel urgency was detected in half of UC patients on long-term advanced therapies, while moderate to severe urgency affected QoL in about a quarter of patients. The prevalence of BU was similar between adult and pediatric UC cohorts. Disease activity is a crucial predictor of bowel urgency. Notably, a small proportion of patients experience moderate to severe urgency despite clinical remission, highlighting the need for active management by healthcare providers. References: 1. Bortlik M, Lukáš M, et al. Analysis of Bowel Urgency in Patients with UC from National Czech CREdIT Registry of IBD Patients, IBA 2025 2. Dubinsky MC, et al. Patient Rep Outcomes. 2022;6(1):114 3. Dubinsky MC, et al. Qual Life Res. 2023;32(12):3403-3415. 4. Gibble TH, et al. J Crohns Colitis. 2024;18(Suppl. 1):i1353-i1354 Conflict of interest: Lukás, Milan: Research Support / Clinical trials: Biogen, Takeda, Janssen Consultant / Speaker: Abbvie, Ferring, Takeda, Janssen Speakers Bureau / Advisory Board Member: Pfizer, Roche, Egis, Celltrion, Takeda, Janssen, Eli Lilly Employee: ISCARE a.s./1stMedical Faculty, Charles University, Prague Bortlik, Martin: Investigator, consultant, or speaker: Abbvie, Takeda, Janssen-Cilag, Celtrion, Roche, Sanofi, Tillotts, Ferring, Alfasigma, Pfizer, PRO.MED.CS Vachova, Iva: Employee and minor shareholder of Eli Lilly and Company, Indianapolis, IN, USA. Hradsky, Ondrej: Lectures/congress fees/consultancy from MSD, AbbVie, Takeda, Sandoz, Nutricia, Ferring, Pfizer, and Lilly.