P122 Efficacy of subcutaneous versus intravenous ustekinumab as maintenance treatment in patients with inflammatory bowel disease

BackgroundUstekinumab is a human interleukin-12 and -23 antagonist used in treatment of inflammatory bowel diseases (IBD). In this indication, it is delivered by single weight-dependant intravenous (IV) infusion followed by 8-weekly 90 mg dose subcutaneous (SC) injections.1 ObjectivesMany of our patients felt that IV infusions provided them with more significant subjective relief compared to SC injections which was supported by recent published data.2 Some of them were empirically switched to IV infusions. The aim of this clinical audit was to retrospectively compare the ‘real life’ efficacy of IV vs SC Ustekinumab in our cohort of patients.Method1. All IBD patients started on Ustekinumab during 2020 and 2021 were included.• The authors retrospectively reviewed patients’ characteristics and treatment outcomes (blood test results including levels of Ustekinumab, clinical symptoms, faecal calprotectin and endoscopy/imaging results), these were recorded in 3 month’s intervals.• We compared the above results in patients who received SC Ustekinumab VS SC--> IV ustekinumab for more than 6 months.Results51 patients were included (51% is male), 88% had Crohn’s disease, 8% UC and 4% indeterminate colitis. These proportions were similar in both groups.43 patients received subcutaneous Ustekinumab and 8 patients were switched from subcutaneous to intravenous Ustekinumab due to subjective lack of response. There were no statistically significant differences in any of the recorded characteristics (see table 1). Overall, 42% in SC group and 40% in IV group showed improvement confirmed on endoscopy or imaging, whereas 25% vs 20% (SC vs IV) patients showed significant progression. Remaining patients had stable though active disease.Abstract P122 Table 1 SC IV SEXMALE (%) 15% 16% AGE in years (MEAN +-SD) 45.4 +- 15.8 45.7 +- 20.8 HOSPITAL ADMISSION DURING TREATMENT 28% 25% Hb levels (mg/dL), mean +- SDAt baselineAt 3 monthsAt 6 monthsAt 9–12 months 126.1 +- 17.2128.7 +- 16.6129.4 +- 17.5128.1 +- 14.9 123.6 +- 26.3125.9 +- 21.7129.5 +- 24.6137.3 +- 12.2 CRP levels (mg/dL), mean +-SDAt baselineAt 3 monthsAt 6 monthsAt 9–12 months 26.3 +- 45.013.0 +- 18.216.8+- 38.219.0 +- 27.4 15.4 +- 11.723.0 +- 29.719.2 +- 15.49.8 +-7.4 Faecal calprotectin levelsAt baselineAt 3 monthsAt 9–12 months 1321 +- 1554617.0 +- 534203.5 +- 248.0 1836 +- 940.0250.0118.0 Ustekinumab levels (mean+-SD)At 3 monthsAt 6 monthsAt 9–12 months 11.5 +- 12.53.6 +- 0.47.7 +- 7.4 n/a3.8 +- 0.410.1 ConclusionsAlt