P669 Adherence to self-administered biologic therapies in inflammatory bowel disease: Experience in a tertiary hospital

Abstract Background Nonadherence to medications is common in patients with inflammatory bowel disease (IBD) and can result in disease complications, therapy escalation, and the need for corticosteroids. The aim of this study was to assess adherence to self-administered (subcutaneous) biologic medications prescribed for IBD and to identify risk factors for biologic nonadherence. Methods A retrospective cohort study was performed on IBD patients starting and receiving subcutaneous biologic therapies from January 2016 to July 2019. Medical records were retrospectively reviewed and demographic and IBD data were collected. A modified medication possession ratio (mMPR) was calculated for the first 12-month treatment and at the end of follow-up (global-42 months). Nonadherence was defined as mMPR of less than 90%. Multiple regression analysis was performed to assess risk factors associated with non-adherence therapy Results A total of 154 patients (84M/70F; mean age starting biologic treatment 36 ±14 years; Crohn’s disease n = 118/ ulcerative colitis n = 31/ indeterminate colitis n = 5) were included; 121 received Adalimumab (ADA) and 33 were on Ustekinumab (UST); 63% of patients were naive to anti-TNF and 16.9% had received >2 previous biological treatment. Mean time from IBD diagnosis to use of subcutaneous biological agent was 16 ± 10 months. Mean time of subcutaneous agents use was 17.6(SD11.0) and 17.08 (SD6.8)months for ADA and UST, respectively. Global nonadherence (n = 154) (≤90% mMPR) was 6.6% for all patients receiving subcutaneous treatment and 6.3% for ADA and 6.5% for UST. Nonadherence during first 12-month treatment (n = 98) was 6.1% for all patients and 2.7 % for ADA and 16% for UST, respectively. In the multivariate analysis, Ustekinumab use was independently associated with higher nonadherence only for first 12-months adherence (OR 6.7, 95% CI 1.1–39.5). Conclusion Self-administered biologic treatment showed adequate global adherence in our study. Using subcutaneous administration for biologic agents in IBD patients forces us to monitor and control their adherence to ensure the therapeutic benefit.

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P626 SARS-CoV-2 seroprevalence in patients with Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.746 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S564-S564

Author(s):

S García Mateo ◽

S J Martínez-Domínguez ◽

M C Aso Gonzalvo ◽

C J Gargallo-Puyuelo ◽

B Gallego Llera ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Potential Risk ◽

Bowel Disease ◽

Biologic Agents ◽

World Health ◽

Indeterminate Colitis ◽

Increased Risk ◽

Potential Risk Factors ◽

Inflammatory Bowel

Abstract Background Patients with Inflammatory Bowel Disease (IBD) suffer from a chronic illness and many of them need immunosuppressive therapy throughout the course of the disease. Consequently, COVID-19 pandemic has caused uncertainty about the possible increased risk of suffering SARS-CoV-2 infection that could confer IBD or its treatments. The aim of this study is to assess SARS-CoV-2 seroprevalence in patients with IBD as well as the existence of potential risk factors for its development. Methods This is a unicentric cross-sectional study developed in IBD unit of University Hospital “Lozano Blesa” of Zaragoza. Patients older than 18 years with established diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis (IC) have been included. A blood sample has been drawn from each patient to detect IgG against SARS-CoV-2 (ELISA method) and each patient has completed a questionnaire to know symptoms related to infection and previous comorbidity. We have performed a descriptive analysis and a univariate analysis to study relationship between potential risk factors and seroconversion against SARS-CoV-2. Results 431 patients have been included, with a mean age of 50.2 ± 14.1 years and a 51.3% of women. Of them, 49.7% suffer from UC, 49.2% CD and 1.2% IC. Related to the treatment, 23.5% receive anti-TNF biologic agents, 13.1% other kind of biologic agents, 9.3% immunomodulators, 7.7% combined treatment (biologic agent and immunomodulator), 33.1% other treatment and 13.3% no treatment. According to World Health Organization (WHO) definitions, 85.6% had not suffered the infection, 7.7% were confirmed cases (only 3 admitted patients) and 6.7% were probable cases. The seroprevalence of SARS-CoV-2 obtained is 8.8%, being significantly higher among confirmed cases than among probable cases (71.0% in confirmed vs 6.9% in probable; RR 10.3; p<0.001). A higher risk of seroconversion has been detected among patients without biologic agents (11.8% in patients without biologic agents vs 5.3% in patients with biologic agents; RR 2.2; p=0.021). No differences have been observed in the seroprevalence of patients with other treatments for IBD or in terms of age, active smoking, level of inflammation markers, the presence of symptoms of infection or hospital admission. Conclusion The seroprevalence of SARS-CoV-2 of Aragon′s patients with IBD is similar to that described in national seroprevalence study of Ministry of Health for the region (8.8%). The treatment with biologic agents is associated with a lower risk of seroconversion

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Inflammatory Bowel Disease and Skin Cancer: An Assessment of Patient Risk Factors, Knowledge, and Skin Practices

Journal of Skin Cancer ◽

10.1155/2016/4632037 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Jessica N. Kimmel ◽

Tiffany H. Taft ◽

Laurie Keefer

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Skin Cancer ◽

Cancer Prevention ◽

Bowel Disease ◽

Skin Cancer Prevention ◽

Indeterminate Colitis ◽

Skin Protection ◽

Increased Risk ◽

Inflammatory Bowel

Objective. Patients with inflammatory bowel disease (IBD) are at increased risk from skin cancer. Aims include assessing IBD patients’ risk factors and knowledge of skin cancer and current skin protection practices to identify gaps in patient education regarding skin cancer prevention in IBD.Methods. IBD patients≥18 years were recruited to complete an online survey.Results. 164 patients (mean age 43.5 years, 63% female) with IBD (67% Crohn’s disease, 31% ulcerative colitis, and 2% indeterminate colitis) were included. 12% (n=19) of patients had a personal history and 34% (n=55) had a family history of skin cancer. Females scored better on skin protection (16.94/32 versus 14.53/32,P≤0.03) and awareness (35.16/40 versus 32.98/40,P≤0.03). Patients over 40 years old scored better on prevention (17.45/28 versus 15.35/28,P=0.03). Patients with skin cancer scored better on prevention (20.56/28 versus 15.75/28,P≤0.001) and skin protection (21.47/32 versus 15.33/32,P≤0.001). 61% of patients recognized the link between skin cancer and IBD.Conclusions. The majority of IBD patients are aware of the link between skin cancer and IBD; however, skin protection practices are suboptimal. This emphasizes the role of healthcare professionals in providing further education for skin cancer prevention in the IBD population.

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Treatment Adherence in Inflammatory Bowel Disease Patients from Argentina: A Multicenter Study

Gastroenterology Research and Practice ◽

10.1155/2020/4060648 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Juan Lasa ◽

Gustavo Correa ◽

Claudia Fuxman ◽

Laura Garbi ◽

Maria Eugenia Linares ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Treatment Adherence ◽

Bowel Disease ◽

Subcutaneous Administration ◽

Cross Sectional Study ◽

Indeterminate Colitis ◽

Cross Sectional ◽

Oral Medications ◽

Modifiable Factors ◽

Inflammatory Bowel

Background and Aim. Treatment adherence is a frequent problem in inflammatory bowel disease (IBD). No study has assessed adherence in Argentinian patients with IBD. The aim of this study was to determine inadequate adherence to oral and parenteral therapies in patients with IBD from Argentina and to identify factors associated with it. Methods. A multicenter cross-sectional study involving seven referral centers from three cities of Argentina was undertaken. Patients with a diagnosis of ulcerative colitis (UC), Crohn’s disease (CD), or indeterminate colitis (IBDU/IC) were invited to answer an anonymous survey, which included a 5-point Likert scale to evaluate adherence to therapies. Independent variables associated with inadequate adherence were evaluated. Results. Overall, 447 UC/IBDU and 135 CD patients were enrolled. Median age was 37 years (range 21-72); 39.8% were male; median time from diagnosis was 6 years (0.5-35). 91.4% were under treatment with at least one oral medication; 50.3% of patients reported inadequate adherence to oral medications. Patients with UC/IBDU had a lower risk of inadequate adherence when compared to patients with CD (OR 0.57 (0.37-0.87)). 21.8% reported inadequate adherence to biologics; subcutaneous administration was significantly associated with inadequate adherence to biologics (OR 4.8 (1.57-14.66)). Conclusion. Inadequate treatment adherence is common among patients with IBD, and potentially modifiable factors were identified.

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