P0675IBD-GAPS: Inflammatory Bowel Disease Guidelines Alignment in Clinical Practice Survey

Abstract Background Inflammatory bowel disease (IBD) affects 500,000 people in the UK. In 2024, one in three patients rated their care as ‘fair’ or ‘poor’. With a rapidly evolving treatment landscape, it is unclear whether clinical practice aligns with IBD treatment guidelines. A survey was conducted to assess healthcare professionals’ (HCPs) self-reported practices in managing moderate-to-severe luminal Crohn’s disease (CD). Methods IBD-GAPS was a cross-sectional survey conducted with UK-based HCPs considered leading IBD specialists. Convenience sampling was used to recruit physicians, nurse specialists and pharmacists. Structured interviews generated quantitative and qualitative data, which were analysed using descriptive statistics and content analysis, respectively. Results A total of 47 HCPs participated between 20 February and 21 March 2025: 29 consultants (61.7%), 5 specialist registrars/fellows (10.6%), 10 nurse consultants/specialists (21.3%), 3 pharmacists (6.4%). Most worked in England (89.4%) and in teaching hospitals (68.1%). Most HCPs use advanced therapy at diagnosis in moderate-to-severe CD (76.6%; Figure A), with proportionally more consultants (25/29; 86.2%) than other HCPs (11/18; 61.1%) reporting this practice. Figure B shows HCPs’ actual and ideal first, second and third-line treatment choices, where infliximab plus azathioprine is the first-line ideal and actual choice for the majority; 90.2% (37/41) reported that these practices reflected the wider multidisciplinary team (MDT). Cost (n = 25) and local pathways (n = 10) were common barriers to using ideal treatment, with proportionally more HCPs from district general hospitals (DGHs) citing pathway restraints (5/13; 38.5%). Biomarkers (46/47; 97.9%), magnetic resonance imaging (34/47; 72.3%) and endoscopy (33/47; 70.2%) were often used to monitor during remission. Small bowel ultrasound was used infrequently (12/47; 25.5%) and concentrated in teaching hospitals (11/32; 34.4%) versus DGHs (1/13; 7.7%). Conclusion Self-reported clinical practice in moderate-to-severe luminal CD was more reflective of recently published evidence than the 2019 British Society of Gastroenterology (BSG) guidelines. Leading IBD experts, primarily from English teaching hospitals, reported using advanced therapy often at diagnosis, with antiTNF plus immunomodulator the most common firstline choice. Practices were reportedly reflective of their wider MDT. Barriers such as costs and local restrictions persist. Updated BSG guidelines were published in June 2025, therefore it will be important to understand changes these will bring to clinical practice in the UK. Conflict of interest: Selinger, Christian Philipp: CPS has received unrestricted research grants from Warner Chilcott, Janssen, Galapagos and AbbVie, has provided consultancy to Warner Chilcott, Dr Falk, AbbVie, Takeda, Fresenius Kabi, Eli Lilly, Galapagos, Ferring, Arena and Janssen, and had speaker arrangements with Warner Chilcott, Dr Falk, Galapagos, AbbVie, MSD, Pfizer, Eli Lilly, BMS, UCB, Fresenius Kabi, Celltrion and Takeda. Kok, Klaartje: Speaker or advisory fees or support for attending conferences from Abbvie, Janssen, Takeda, Galapagos, Lilly, Falk. Gordon, Hannah: Personal Fees: Speaker fees : Janssen (J & J), Ferring, Takeda, AbbVie, Lilly Consultancy fees: AbbVie, Galapagos, Janssen (J & J), Takeda, Lilly Patel, Kamal Vijaykant: Grant to support research from AbbVie. Educational support, speaker fees, advisory boards: Johnson and Johnson, AbbVie, Alfasigma, Celltrion, DrFalk, Lily, Pfizer, and Takeda. Quinn, Jenny: Employee of Johnson and Johnson Innovative Medicine. Munje, Chinmay: Employee of Johnson and Johnson Innovative Medicine at the time this research was conducted. Currently employee of Amplity, Gerrards Cross, UK Beiderbeck, Barbara: At the time this work was conducted, I was employed as a Medical Science Liaison at Johnson & Johnson. I am currently employed by Sanofi. I have no other conflicts of interest to declare. Francis-Graham, Seth: Employee of Costello Medical, a vendor that provides services for fees to industry, governmental and non-governmental organisations. Services include the design and delivery of real-world evidence studies, as well as medical writing support Sullivan, Eve: Employee of Costello Medical, which received fees from J & J Innovative Medicine for conducting this work. Smith, Madeleine: Employee of Costello Medical, which received fees from J & J Innovative Medicine for conducting this work. Burton, Louisa: Employee of Costello Medical, which received fees from J & J Innovative Medicine for conducting this work. Moran, Gordon: Gordon Moran has received research grants from Astra Zeneca, Bristol Myers Squibb, Jansen and Pfizer. He has received consulting fee from Alimentiv, Satisfai Health, Takeda, Abbvie, Jansen, Motilent, and Pfizer. He has received speaker honoraria from Abbvie, Jansen and Bristol Myers Squibb. He has received financial support for attending international meetings from Jansen and Abbvie.