P0473 Study of the positioning and therapeutic persistence of advanced therapies in real-life inflammatory bowel diseases (IBD) in non-academic hospital centres: the PERSIST’ANGH study

Abstract Background Management of inflammatory bowel diseases (IBD) now relies on a comprehensive and personalized approach. Comorbidities (age, obesity/overweight, metabolic/cardiovascular diseases, past cancer, extra-intestinal manifestations) and pregnancy may influence the choice and persistence of advanced therapies (AT). The PERSIST’ANGH study aimed to analyze, in real-life practice, the positioning and persistence of ATs in general hospital centers. Methods PERSIST’ANGH is an ambispective, multicentre observational study (eCRF) enrolling patients with Crohn’s disease (CD) or ulcerative colitis (UC) treated with at least one AT in non-university hospitals. The primary objective is to describe AT sequences and their persistence from first-line initiation. This first analysis focuses on baseline characteristics at inclusion. Results By 15 September 2025, 1,362 patients were included across 21 centers; 1,162 were analyzed: 62% CD (n = 722) and 38% UC (n = 440). Median age was 40 years (CD 39 vs UC 42; p = 0.013); 33% were >50 years and 52% were male. Mean BMI was 25.3 kg/m²; 29% were overweight and 16% obese. Active smoking was reported in 20% of CD vs 9% of UC (p < 0.001). In CD, ileal (L1) and ileocolonic (L3) disease accounted for 42% and 40%; inflammatory phenotype (B1) for 56%; ano-perineal lesions for 26%. Surgery occurred in 328 patients: 191 luminal (61%) and 121 ano-perineal (39%). In UC, extent was pancolitis (E3) 52%, left-sided (E2) 38%, and proctitis (E1) 11%. Comorbidities were significantly more frequent after 50 years: hypertension (28% vs 3%), diabetes (12% vs 1%) and dyslipidaemia (16% vs 1%) (all p < 0.001). A cancer history was reported in 58 cases [cured (n = 35), remission (n = 15), active (n = 8)], representing 13% of > 50 yrs vs 1% of < 50 yrs (p < 0.001), more common in UC (8%) than CD (4%). Most frequent cancers were non-melanocytic skin (n = 9), breast (n = 8) and prostate (n = 8). Extra-intestinal manifestations occurred in 19%: axial (34%) or peripheral arthritis (25%), psoriasis (11%), erythema nodosum (6%) and primary sclerosing cholangitis (12%). A total of 142 pregnancies were recorded; 90% reached term, with 70% vaginal delivery. AT was maintained throughout pregnancy in 29%. Conclusion This cohort is consistent with published data. Metabolic/cardiovascular comorbidities and past cancer are markedly more frequent after 50 years, highlighting the need for holistic assessment before initiating or continuing AT. Treatment continuation during pregnancy remains limited. These descriptive findings constitute the first stage of PERSIST’ANGH; analyses of AT sequencing and persistence will follow to clarify real-life therapeutic strategies. Conflict of interest: Prof. Nahon, Stéphane: No conflict of interest Paupard, Thierry: No conflict of interest Frédéric, Heluwaert: No conflict of interest Mathias, Vidon: No conflict of interest Armand, Garioud: No conflict of interest Sinda, Tlili: No conflict of interest Delobel, Jean Bernard: No conflict of interest Flavien, Dautrecque: No conflict of interest Edoardo, Poli: No conflict of interest Faiza, Khemissa: No conflict of interest Kaassis, Mehdi: No conflict of interest Blain, Antoine: No conflict of interest Sarah, Taieb: No conflict of interest René-Louis, Vitte: No conflict of interest Lalieu, Ambroise: No conflict of interest Irina, Raoto: No conflict of interest Benjamin, Anon: No conflict of interest Skinazi, Florence: No conflict of interest Morgane, Amil: No conflict of interest Tristan, Delory: No conflict of interest Céline, Montuclard: No conflict of interest Julia, Roux: No conflict of interest