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No studies evaluating the rapidity of response to biological therapies are available for Crohn's disease (CD). The aim of this study was to evaluate rapidity of onset of clinical response and impact on quality of life (QoL) of adalimumab therapy in adult anti-TNF-naïve patients with moderately-to-severely active CD.RAPIDA was an open-label, single-arm, prospective, multicenter clinical trial. Adult patients with moderately-to-severely active luminal CD, anti-TNF-naïve, and unresponsive to conventional therapy were treated with adalimumab. Clinical disease activity, QoL and inflammatory biomarkers were measured at day 4, and weeks 1, 2, 4, and 12 after treatment initiation.Eighty-six patients were included in the intention-to-treat (ITT) analyses. Clinical disease activity was reduced from a median of 9.0 points to 6.0 points at day 4. Clinical response (≥ 3-point reduction in the Harvey-Bradshaw Index, HBI) was achieved by 61.6% (d4) and 75.6% (w1) of patients in the ITT population (median 2.5 days) and with non-responder imputation (NRI), by 55.8% and 53.4%, respectively. The proportion of patients in clinical remission (HBI5) at weeks 2 and 4 in the ITT population was 54.7% and 62.8%, respectively (median 7.0 days), and 38.4% and 45.3% in the NRI population. All QoL scores significantly improved and inflammatory biomarkers significantly decreased from day 4 onwards (p0.0001).Rapid clinical response and remission, improvement in QoL and fatigue, and a reduction of inflammatory biomarkers were achieved with adalimumab as early as day 4 in adult anti-TNF-naïve patients with moderately-to-severely active CD.

Objectives: To assess the rates and severity of SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory disease (AI/IMID) treated with anticytokine biologics (AB) or Janus Kinase inhibitors (JAKi), and to compare the types of confinement observed by AI/IMID patients and the general population. Methodology: A case-control study nested within a retrospective observational study. Subjects: AI/IMID patients followed by rheumatology, dermatology and digestology specialists and who were receiving treatment with AB/JAKi. Controls were selected from our Primary Care Centers. The main outcome was SARS-CoV-2 infection and severity. The secondary outcome was the type of confinement (strict, standard, lax, and no confinement). Results: Three hundred and sixty-seven patients (54·8% men, mean age 52 years) and 193 controls (53·4% men, mean age 52 years). In patients’ group, 95·6% were receiving AB treatment, and 43·3% had at least one risk factor for COVID compared to 37·8% of controls. Cumulative rates of COVID infection were 10·1% in the AI/IMID group and 13·5% in controls (p=0·228). Strict confinement was the most frequent form in both groups; lax confinement was more common in the control group (p=0·013, OR=0·62). There were no differences in the incidence of COVID-19 according to type of confinement. Conclusions: The incidence of COVID-19 infection in our cohort is similar to that reported in other series. None of our patients developed severe COVID-19 infection. We observed that strict confinement was predominant in both groups and was higher in the AI/IMID patients. Lax confinement was more frequent in the control group. Funding: This project has obtained a research grant from the Catalan Society of Rheumatology which has allowed the project to be carried out. Declaration of Interest: None to declare. Ethical Approval: The protocol was approved by an independent Clinical Research Ethics Committee (Comite d'Etica d'Investigacio Clinica de la Fundacio Unio Catalana d'Hospitals, protocol number CEIC 20/45).

Resumen Introduccion Infliximab ha demostrado su eficacia en evitar la colectomia a corto y medio plazo en los pacientes con colitis ulcerosa corticorrefractarios (CUCR). No obstante, existen pocos datos acerca del tratamiento de mantenimiento mas adecuado en los pacientes con CUCR que han respondido al tratamiento de induccion a infliximab. El objetivo del estudio es comparar la evolucion a largo plazo de los pacientes corticorrefractarios que han respondido al tratamiento de induccion a infliximab segun hayan seguido tratamiento de mantenimiento con azatioprina en monoterapia o infliximab. Pacientes y metodos Se seleccionaron los pacientes ingresados en 3 centros entre enero de 2005 y diciembre de 2011 por un brote moderado-grave de CUCR que habian respondido a las 3 dosis de induccion de infliximab sin necesidad de colectomia antes de la semana 22 despues de la primera infusion. Resultados Se incluyeron 22 pacientes, 9 (37%) siguieron tratamiento con azatioprina y 15 (63%) con infliximab. Despues de una mediana de 18 meses de seguimiento, los corticoides se pudieron retirar en todos. De los que siguieron tratamiento con azatioprina, infliximab tuvo que ser reintroducido en 4 (44%). No hubo ninguna colectomia. De los 15 pacientes que siguieron tratamiento con infliximab, este requirio ser intensificado en el 53%, aunque en 9 (65%) pudo retirarse por remision clinica. Cuatro pacientes (16%) requirieron colectomia. Conclusiones Segun los resultados del estudio parece recomendable seguir tratamiento con infliximab, incluso en los pacientes no expuestos previamente a tiopurinas, dada la necesidad de reintroduccion de infliximab si se sigue tratamiento con azatioprina en monoterapia.

DOP051 Usefulness of a faecal calprotectin rapid semiquantitative test in predicting relapse in patients with ulcerative colitis in remission E. Garcia-Planella1, M. Manyosa2,3, M. Chaparro4, M. Barreirode-Acosta5, B. Beltran6, E. Ricart7, V. Garcia-Sanchez8, M. Esteve9, M. Piqueras10, F. Bermejo11, A. Lopez-Sanroman12, C. Taxonera12, J. Llao13, J.P. Gisbert4, E. Cabre3, E. Domenech3 *. 1Hospital de la Santa Creu i Sant Pau, Gastroenterology, Barcelona, Spain, 2Hospital Universitari Germans Trias i Pujol and CIBERehd, Gastroenterology Unit, Badalona, Spain, 3Hospital Universitari Germans Trias i Pujol, Gastroenterology, Badalona, Spain, 4Hospital La Princesa, Gastroenterology, Madrid, Spain, 5Hospital Universitario de Santiago, Gastroenterology, Santiago de Compostela, Spain, 6IIS Hospital La Fe, Gastroenterology, Valencia, Spain, 7Hospital Clinic, Gastroenterology, Barcelona, Spain, 8Hospital Reina Sofia, Gastroenterology, Cordoba, Spain, 9Hospital Mutua Terrassa, Gastroenterology, Terrassa, Spain, 10Consorci Sanitari Terrassa, Gastroenterology, Terrassa, Spain, 11Hospital de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain, 12Hospital Ramon y Cajal, Gastroenterology, Madrid, Spain, 13Xarxa Hospitalaria Althaia, Gastroenterology, Manresa, Spain