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• W2120724043 abstract "s of the 4th Congress of ECCO the European Crohn’s and Colitis Organisation S91 (year 1 5) to 83.0% (year 11 15). There was no relation of these data age, gender, disease extension, and the medication. Conclusion: UC disease activity was reduced during the long time course independent of the other investigated disease parameters. P204 IBD care in Europe: a comparative audit of ulcerative colitis care between Oxford and Milan using the validated National UK IBD Audit Tool A. Cassinotti1 *, S. Keshav2, S. Ardizzone1, N. Mortensen2, G. Sampietro1, P. Fociani1, B.F. Warren2, G. Vago1, D. Foschi1, B. George2, G. Bianchi Porro1, S. Travis2. 1L. Sacco University Hospital, Milan, Italy, 2J. Radcliffe Hospital, Oxford, United Kingdom Background: The National UK IBD Audit tool is an electronic database created to improve the quality and safety of care for IBD patients by auditing individual patient care, service resources and organization against national standards. Aims: To compare the organization and process of UC care between 2 IBD services in Oxford (UK) and Milan (Italy), using the National UK IBD Audit tool, as a pilot study to evaluate its application outside national boundaries. Methods: Clinical and demographic data of patients with UC, consecutively admitted during a 2 month period, were collected using the IBD Audit tool. The data were compared between the 2 centres, to each other and to the UK IBD standards obtained by previous audit analyses performed in Oxford in 2006. Results: 20 (60% male, age 28 73) and 26 (42% male, age 18 85) patients with UC were admitted in Oxford and Milan, respectively. Median duration of hospitalization was 10 days (range 1 25) in Oxford and 7 (4 22) days in Milan. 13/20 (65%) and 2/26 (8%) were admitted with acute severe colitis (ASC) respectively. Most admissions in Milan were planned admissions for moderately active treatment-refractory disease. No patient died. Oxford had a higher surgery rate (4/13, 31% vs 0/5, 0%) for ASC, while use of ciclosporin or infliximab as rescue therapy was similar (38 % (5/13) in Oxford vs 40% (2/5) in Milan), with similar rate of complete response (80% vs 100%) in those admitted with ASC. The following areas did not reach the standards set for the 2006 UK IBD Audit: the lack in Milan of IBD specialist nurses (0% vs 100%), stool sampling to exclude Cl. difficile (57% Milan vs 71% Oxford), heparin prophylaxis (19% vs 95%) and abdominal radiography on admission (23% Milan vs 86% Oxford). Endoscopy consisted mainly of colonoscopy in Milan (92%) and flexible sigmoidoscopy in Oxford (64%), reflecting the different biological activity. Over CRP, Milan used also ESR as a biomarker of activity (96% vs 29% Oxford). Both centres paid little attention to bone protection in steroids users (50 56%). Since the previous audit in 2006, Oxford showed improvements with regard to IBD specialist nurse visits (25% 2006 to 100% 2008), stool samples (31% to 71%), prophylactic heparin (81% to 95%), and bone protection (7% to 56%). Conclusions: Procedural differences between Oxford and Milan are very similar for audits of both UC and Crohn’s disease (companion abstract), indicating systematic differences that could be resolved by organizational change. The UK IBD Audit tool is an easy instrument to assess the processes and outcomes of care delivery in IBD and can be applied also outside UK. P205 Outcome of patients with Crohn’s disease and primary sclerosing cholangitis in CHARM and GAIN R. Panaccione1 *, P. Rutgeerts2, D. Wolf3, W. Selby4, M. Russel5, K.G. Lomax6, P.F. Pollack6. 1University of Calgary, Calgary, AB, Canada, 2University Hospital of Gasthuisberg, Leuven, Belgium, 3Atlanta Gastroenterology Associates, Atlanta, GA, USA, 4Royal Prince Alfred Hospital, Sydney, Australia, 5Gastroenterology and Hepatology Department, Medisch Spectrum Twente, Enschede, Netherlands, 6Abbott, Parsippany, NJ, USA Introduction: Crohn’s disease (CD) is frequently complicated by extra-intestinal manifestations (EIMs), such as primary sclerosing cholangitis (PSC), a progressive inflammatory disease involving the intraand extra-hepatic biliary tree. Adalimumab is approved for the treatment of CD, but its effects in PSC are unknown. We assessed the efficacy and safety of adalimumab in CD patients with PSC enrolled in the CHARM and GAIN studies. Methods: All 854 patients enrolled in CHARM received openlabel induction adalimumab 80/40mg at Weeks 0/2 [1]. At Week 4, patients were randomized to placebo; adalimumab 40mg every other week (eow); or adalimumab 40mg weekly, and followed through Week 56. At or after Week 12, patients with flares/nonresponse could receive open-label adalimumab 40mg eow and advance to weekly dosing if necessary. GAIN was a 4-week induction trial of adalimumab in infliximab-failure patients [2]. Patients (N = 325) were randomized to induction therapy with either placebo or adalimumab 160/80mg at Weeks 0/2. Short-term (4-week) data reflecting any acute changes were available for all PSC patients, and longer term follow-up was available only for CHARM patients. A PSC diagnosis did not preclude enrollment in either study, provided patients did not have AST or ALT concentrations >1.75 times the upper limit of reference ranges or total bilirubin concentrations >3mg/dL. Outcomes for patients in CHARM or GAIN with a diagnosis of PSC Patient/ Study Dosing Duration CDAI (Baseline to last visit) LFTs at baseline and during study 1/CHARM DB ADA weekly to OL ADA eow (Week 12) Finished study 312 to 32 Mildly to moderately elevated, stable throughout study 2/CHARM DB PBO Through" @default.
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• W2120724043 title "P204 - IBD care in Europe: a comparative audit of ulcerative colitis care between Oxford and Milan using the validated National UK IBD Audit Tool" @default.
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