Abstracts i905 Response to induction therapy predicted week 30 remission.Of the responders,19 (59%) children with CD and 31 (60%) with UC achieved SFR at week 30,while the corresponding figures for those not achieving response were 3 (12%; p=0.004) in CD and 5 (29%; p=0.03) in UC.Similarly,in multivariable model,response to induction treatment was highly associated with SFR at week 30,in both CD (OR 11.2 [95%CI 2.3-73]) and UC (OR 4.8 [95%CI 1.4-19]).Of the 22 patients who were responders but not remitters at week 14,four eventually achieved SFR at week 30 (1/10 [10%] in CD and 3/12 [25%] in UC) By week 30,159 AE's were reported by 72 children including one case of Hodgkin's lymphoma (VDZ was resumed after completing the chemotherapy);the patient was never exposed to thiopurines.No cases of progressive multifocal leukoencephalopathy or deaths were reported. Thirty-six AEs in 23 (16%) children were classified as possibly related to VDZ,11 of which (31%) were moderate and the others mild.Four children (1.4%) discontinued treatment due to AEs (one due to infusion reaction,one leukocytoclastic vasculitis,one azotemia and one due to fever and malaise Conclusion: In this prospective multicenter study,VDZ was effective for maintaining remission in children with CD, and more so in UC.Contraty to common notions,children with CD not achieving complete remission by week 14 had a very low likelihood of entering remission thereafter. Safety profile was generally good except for one lymphoma case with questionable relation to VDZ Abstract citation ID: jjac190.0905 P775 Disease activity and treatment patterns of newly diagnosed adult patients with Crohn's disease in Japan: Interim analysis of inception cohort registry study of patients with Crohn's disease (iCREST-CD) Medical and Dental University, Department of Gastroenterology and Hepatology, Bunkyo-ku- Tokyo, Japan, 4Yokohama City University Medical Centre, Inflammatory Bowel Disease Centre, Minami-kuYokohama- Kanagawa, Japan, 5Kyorin University School of Medicine, Department of Gastroenterology and Hepatology, Mitaka- Tokyo, Japan, 6Tohoku University Graduate School of Medicine, Division of Gastroenterology, Sendai- Miyagi, Japan, 7Fukuoka University Chikushi Hospital, Department of Inflammatory bowel disease center, Chikushino- Fukuoka, Japan, 8Shiga University of Medical Science, Division of Digestive Endoscopy, Otsu- Shiga, Japan, 9Keio University, Division of Gastroenterology and Hepatology- Department of Internal Medicine, Shinjiku-ku- Tokyo, Japan, 10Yokkaichi Hazu Medical Center, Department of Surgery and Inflammatory Bowel Disease Center, Yokkaichi- Mie, Japan, 11Sapporo-Kosei General Hospital, IBD CenterHokkaido Preventive Welfare Federation of Agricultural Cooperative, Sapporo- Hokkaido, Japan, 12Kyushu University, Department of Medicine and Clinical Science- Graduate School of Medical Sciences, S. Shinzaki1, K. Matsuoka2, T. Fujii3, R. Okamoto3, A. Yamada2, R. Kunisaki4, M. Matsuura5, K. Watanabe1, H. Shiga6, N. Takatsu7, S. Bamba8, Y. Mikami9, T. Yamamoto10, T. Shimoyama10, S. Motoya11, T. Torisu12, T. Kobayashi13, N. Ohmiya14, M. Saruta15, K. Matsuda16, T. Matsumoto17, H. Nakase18, A. Maemoto19, Y. Murata20, S. Yoshigoe20, H. Tsuchiya20, T. Hisamatsu5 1 Hyogo Medical University, Center for Inflammatory Bowel DiseaseDivision of Gastroenterology and Hepatology- Department of Internal Medicine, Nishinomiya- Hyogo, Japan, 2Toho University Sakura Medical Center, Department of Internal Medicine, Sakura- Chiba, Japan, 3Tokyo Downloaded from https://academic.oup.com/ecco-jcc/article/17/Supplement_1/i905/7010221 by guest on 12 September 2023 for Children & Young People, The Royal Hospital for Children & Young People, Edinburgh, United Kingdom Background: We previously reported the effectiveness of vedolizumab (VDZ) to induce remission in children with CD and UC enrolled in the prospective,multicenter VEDOKIDS study.In this extended analysis,we aimed to explore the effectiveness and safety of VDZ to maintain remission through week 30 Methods: Children with CD or UC commenced on VDZ at any stage of the disease were followed at baseline and 2, 6, 14 and 30 weeks thereafter.Explicit demographic,clinical and safety data were prospectively recorded.The primary outcome was steroid-and EEN-free clinical remission (SFR) at 30 weeks,analyzed under the ITT principle with nonresponse imputation.Response was defined as change of ≥ 20 points in PUCAI or >20 points in wPCDAI and clinical remission as PUCAI<10 or wPCDAI<12.5. Adverse events (AE's) were classified as severe or non-severe and related or unrelated to VDZ Results: A total of 142 children were enrolled (65 [46%] CD,77 [54%] UC;Table).At the end of the induction period,the rates of response were 75% in UC vs 64% in CD (p=0.2),of remission 52% vs 38% (p=0.1),and of SFR 47% vs 32% (p=0.08),respectively.At week 30,SFR rates were 47% in UC and 34% in CD (p=0.1);outcomes were also numerically higher in UC,but without statistical significance(Figure) Abstract P775 Abstract P775 Abstract P775 i906 Poster presentations Downloaded from https://academic.oup.com/ecco-jcc/article/17/Supplement_1/i905/7010221 by guest on 12 September 2023 Abstracts i907 Abstract P775 Background: Biologics are commonly used for the treatment of Crohn’s disase (CD); however, the proportion of biologics used and their initiation time from diagnosis differs widely between different regions. There is limited information about the patient characteristics and the treatment persistence of each initial biologics, and the treatment persistence of top-down and step-up therapy. iCREST-CD is a prospective, non-interventional, longitudinal, observational registry study conducted at 19 tertiary centres to understand the characteristics of CD treatments in actual clinical settings in Japan. We conducted an interim analysis (cutoff date: 30 June 2022) of iCREST-CD to mainly evaluate the indication and outcomes of initial biologic therapy. Methods: Patients newly diagnosed with CD after June 2016 based on the diagnostic criteria of the Japanese Guidelines, aged ≥16 years at the time of informed consent with no prior exposure to biologics were enrolled. Patient demographics, clinical data, disease activity and medical treatment were recorded. Biologic use without prior steroid use was defined as top-down and biologic use with prior steroid use was defined as step-up. Results: A total of 672 eligible patients (68.2% male) with mean age (±SD) of 29.4 (13.1) years were analysed. Cumulative proportion of patients prescribed 5-aminosalicylic acid, steroids, immunomodulators, and biologics at 6- and 12-months from diagnosis were 71.3%, 40.6%, 31.4%, and 47.5%; and 75.0%, 43.6%, 36.0%, and 59.7%, respectively (Figure 1). A total of 498 patients received biological therapy—infliximab (IFX; 121 [24.3%]), adalimumab (ADA; 244 [49.0%]), ustekinumab (UST; 107 [21.5%]), and vedolizumab (VDZ; 26 [5.2%]). The mean age (±SD) at the initiation of biologic treatment was IFX: 28.2 (11.3), ADA: 26.6 (10.8), UST: 30.4 (14.1), and VDZ: 36.2 (17.4), and the mean (±SD) levels of C-reactive protein (CRP) (mg/L) was IFX: 25.9 (26.8), ADA: 18.9 (26.0), UST: 13.5 (17.9), and VDZ: 9.5 (19.0) (Table.1). The initial biologic treatment persistence rates of IFX, ADA, UST and VDZ at 36-months were 77.5%, 75.8%, 79.8%, and 49.0%, respectively (Figure 2). Patients receiving top-down and step-up therapy were 284 (57.0%) and 214 (43.0%), respectively. The treatment persistence rate of initial biologics by top-down and step-up therapy at 36-months from diagnosis was 81.6% and 66.9%, respectively (P=0.001) (Figure 3). Conclusion: This registry study that demonstrated the treatment persistence rate of initial biologic therapy was significantly higher in the top-down than the step-up approach. Downloaded from https://academic.oup.com/ecco-jcc/article/17/Supplement_1/i905/7010221 by guest on 12 September 2023 Higashi-ku- Fukuoka, Japan, 13Kitasato University Kitasato Institute Hospital, Center for Advanced IBD Research and Treatment, Minato-ku- Tokyo, Japan, 14Fujita Health University School of Medicine, Department of Advanced Endoscopy, Toyoake- Aichi, Japan, 15The Jikei University School of Medicine, Division of Gastroenterology and Hepatology- Department of Internal Medicine, Minato-kuTokyo, Japan, 16Toyama Prefectural Central Hospital, Department of Gastroenterology, Toyama- Toyama, Japan, 17Iwate Medical University, Division of Gastroenterology- Department of Internal Medicine- School of Medicine, Morioka- Iwate, Japan, 18Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo- Hokkaido, Japan, 19Sapporo Higashi Tokushukai Hospital, IBD Center, Sapporo- Hokkaido, Japan, 20Janssen Pharmaceutical K.K., Medical Affairs Division, Chiyoda-ku- Tokyo, Japan