P0770 Real world experience of Upadacitinib at three UK district general hospitals: monitoring and outcomes.

Abstract Background Upadacitinib is a JAKi inhibitor that is used to effectively treat moderate to severe inflammatory bowel disease. It is an oral therapy that requires monitoring including blood tests for cholesterol. The aim of this study was to collate data from the three independent hospital trusts to examine monitoring and therapy outcomes in concordance with local and national guidelines (1, 4) Methods A retrospective study on data taken at each trust from patients on Upadacitinib was collated and analysed using an Excel spreadsheet. The data was interpreted to find themes in relation to clinical outcomes, including if clinical remission was achieved, if cholesterol checks were monitored and dosing of maintenance therapy. Results A total of 54 patients from the three trusts were included in this study.66.6% of patients had Ulcerative colitis with 33.3% having Crohns disease. (N = 18 Crohns, 36 Ulcerative colitis) There were more male than female patients comparable with a recent study (3) with 66.6% male, 33.3% female. 51.85% of the patients had been diagnosed over 5 years (N = 28) with 35.18% being diagnosed between 1-3 years (N = 19). We examined previous exposure to advanced therapy of which 42.59% (N = 23) had one previous advanced therapy, 25.9% were exposed to 2 (N = 14) and 18.51% (N = 10) 3 previous therapies. Naïve patients equated to 12.96% (N = 7) suggesting it is not used first line unless in specific circumstances. The cholesterol monitoring was highlighted and done within local and national guidelines (1,2,4) with baseline blood tests performed on 88.8% of patients and again 88.8% (N = 48) at 12 weeks. Statins were only required in 18.51% (N = 10) of patients. Clinical remission and time to achieve this was examined with 29.6% of patients in clinical remission at 12 months (N = 16), 27.7% at 6-12 months (N = 15) and 22.2% in less than 6 months (N = 10). There were 11 patients who had a reported loss of response, surgery or switched therapies within the 12 months studied. The maintenance dose of 30mg daily was used for 90.7% (N = 49) of the patients with only 9.25% (N = 5) using 15mgs daily. Conclusion The real world experience as a collective was favourable for using Upadacitinib in selective patients. The results were comparable to a recent larger study (3), it highlighted that national and local guidelines were adhered to when Upadacitinib is used in the sequencing of therapies. References: 1. GMMMG (2023) High cost drugs pathways for inflammatory bowel disease in adults. 2. www.crohnsandcolitis.org.uk/media/zxipqysq/upadacitinib Accessed Nov 20253. Panaccione R, Vermeire S, Danese S, Higgins PDR, Litchenstein GR, Nakase H et al (2025) Long term efficacy and safety of Upadacitinb in patients with moderately to severely active ulcerative colitis: an interim analysis of the phase 3 U-ACTIVATE long term extension study. The Lancet, volume 10, issue 6, p507-519 4. NICE guidance TA856 (2023) Conflict of interest: Ms. Campbell, Rachel: Tillotts - nurse education Takeda - nurse education J & J clinical research Davies, Jane: No conflict of interest Nelson, Elizabeth: None Dodgson, Samantha: No conflict of interest Cowell, Amy: No conflict of interest