S568 Poster presentations P701 New onset spondyloarthropathy in vedolizumab treated IBD patients A.M. Tetley 1 , T. Lobaton 2 , M. Truyens 2 , K.H. Katsanos 3 , K.H.N. de Boer 4 , A. Pattinson 5 , T. Molnar 6 , R. Filip 7 , G. Michalopoulos 8 , S. Sebastian* 5 1 Gastroenterology, Hull York Medical School, Hull, UK, 2 Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium, 3 University of Ioannina School of Health Sciences, Division of Gastroenterology, Ioannina, Greece, 4 Department of Gastroenterology and Hepatology, Amsterdam UMC- VU University Medical Center, Amsterdam, Netherlands Antilles, 5 IBD Unit- Department of Gastroenterology, Hull University Teaching Hospitals NHS Trust, Hull, UK, 6 First Department of Medicine, University of Szeged, Szeged, Hungary, 7 Department of Gastroenterology, Clinical Hospital 2- University of Rzeszow, Rzeszow, Poland, 8 Gastroenterology Department, Tzaneion General Hospital of Piraeus, 8, Piraeus, Greece Background: Patients with IBD may have associated spondyloar- thropathy. Vedolizumab is used for IBD with its actions considered to be gut specifc but the impact of this treatment on existing arth- ritis or development of arthritis is uncertain. Integrins and adhesion molecules play a role in the interception of recirculating activated lymphocytes between the gut and the synovial membrane due to the inhibition of the alpha4beta7 integrin homing at the level of the gut. We aimed to describe characteristics and outcomes of spondyloar- thropathy in IBD patients treated with vedolizumab. Methods: We retrospectively collected data on a multicentre cohort of IBD patients with arthropathy which developed following use of Vedolizumab for IBD. This was a part of the European Crohn`s and Colitis Organisation (ECCO) initiated CONFER (Collaborative Network for Exceptionally Rare case reports) project. Data were recorded on a standardised case report form and analysed with de- scriptive statistics. Results: We report data on 14 cases of new onset spondyloarthrop- athy and 1 case of worsening of pre-existing arthropathy from 7 contributing centres. Vedolizumab was used for 6 patients with CD and 8 patients with UC. IBD was in remission in all but 3 patients at the time of development of the joint features. Sacroiliitis was the manifestation in 10 patients, 3 of whom had both sacroiliitis and peripheral arthritis. Three patients had peripheral arthritis alone and one patient had peripheral arthritis with enthesitis. One patient had worsening of peripheral arthropathy following use of vedolizumab. Raised infammatory markers (CRP, ESR or both) were recorded only in one-third of the patients. MRI was abnormal in 9 patients being the marrow oedema in SI joints the commonest feature. One patient had abnormal bone scintigraphy and in another patient plain X-ray and ultrasound was used in confrming diagnosis. Eight of the patients developed arthropathy within days after a single infu- sion of vedolizumab. fve patients needed hospitalisation for treat- ment The treatments used included systemic steroids (11 patients), Intraarticular steroids (3) NSAID (2 patients), Cox inhibitor (1), methotrexate (2) Hydroxychloroquine (1). Vedolizumab was dis- continued in 11 of the patients. In the majority of patients (11/15) it took many months to resolve the arthropathy. On re-challenge with vedolizumab, the arthropathy recurred in 2 out of the 3 patients. Conclusion: This case series demonstrates the potential risk for de- velopment of spondyloarthropathy with vedlizumab in IBD patients which is unrelated to the activity of IBD and can have signifcant impact including need for use for systemic steroids and hospitalisa- tion. Larger prospective cohorts are needed to confrm these results. P702 Treatment decisions in older infammatory bowel disease patients: Applying gut feeling in an evidence-based era? A qualitative study S. Waars* 1 , V. Asscher 1 , A. Pieterse 2 , A. van der Meulen-de Jong 1 , S. Mooijaart 3,4 , J. Maljaars 1 1 Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands, 2 Medical Decision Making- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands, 3 Department of Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands, 4 Institute for Evidence-Based Medicine in Old Age IEMO, Institute for Evidence-Based Medicine in Old Age IEMO, Leiden, The Netherlands Background: The population of older patients with infamma- tory bowel diseases (IBD) is increasing. Treating older patients is challenging as they are characterised by heterogeneity in geriatric domains, such as functional, social or mental status. Although treat- ment guidelines do not distinguish between older and adult patients with IBD, several studies have found a difference in applied treat- ment strategies. It is unknown which considerations contribute to this. Therefore, we performed semi-structured interviews with IBD gastroenterologists and IBD nurses to assess a) which patient char- acteristics they consider and b) which treatment goals they pursue in older IBD patients, compared with adult IBD patients and c) what view they have on prescribing IBD medications in older IBD patients. Methods: IBD gastroenterologists and IBD nurses practicing throughout The Netherlands were asked to participate. Purposive sampling ensured a heterogenous population. Interviews took place in May or July 2019 were audio recorded and conducted face to face. Two researchers coded the verbatim transcripts independently. Codes and themes were obtained inductively and were fnalised in Figure 3. Forest plot of studies reporting CRP before and after vitamin D. Downloaded from https://academic.oup.com/ecco-jcc/article/14/Supplement_1/S568/5705380 by guest on 08 January 2024