OP004 Early combined immunosuppression for the management of Crohn's disease: A community-based cluster randomized trial

s of the 9th Congress of ECCO the European Crohn’s and Colitis Organisation S3 Results: Twenty-one centers (1084 patients) were assigned to ECI and 18 (898 patients) to CM. The mean age of the patients was 44.2 in the ECI group and 44.1 in the CM group. Mean HBS scores were 4.1 in both groups. The proportion of patients in the ECI and CM groups who received combination of antimetabolite/TNF-antagonist by 12 months was 15.1% and 6.5% P< 0.001) and 19.7% and 9.6% by 24 months (P< 0.001). Mean % (SD) remission rates in the ECI and CM groups were 66 (14) and 62 (17) at 12 months (P= 0.65) and 73 (8) and 65 (17) at 24 months (P= 0.35). However, highly significant and clinically important differences in the rates of complications, surgeries, and the combined outcome of hospitalizations, complications, and surgeries were observed in favor of ECI over 24 months (Figure 2). The 24 month actuarial estimates for the combined outcome were 27.7% and 35.1% in the ECI and CM groups, respectively (hazard ratio adjusted for CD caseload and country: 0.74 [0.62, 0.87, P< 0.001]). Figure 2. Hospitalizations, complications*, and surgeries for patients in the ECI and CM groups over 24 months. *Abscess, new fistula, extra-intestinal manifestations of CD and serious AEs. Conclusions: Community-based data indicate that (1) a symptom based conventional approach to CD management may not be optimal and (2) ECI may be more effective in preventing CD-related complications. OP005 Is elderly-onset ulcerative colitis a different entity? Natural disease course and treatment response compared to adult-onset disease in the population-based IBD-SL cohort S. Jeuring1,2 *, T. Van den Heuvel1,2, M. Zeegers3,4, W. Hameeteman1, M. Romberg-Camps5, L. Oostenbrug6, A. Masclee1,2, D. Jonkers1,2, M. Pierik1,2. 1Maastricht University Medical Center+, Internal Medicine Division Gastroenterology-Hepatology, Maastricht, Netherlands, 2Maastricht University Medical Center+, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht, Netherlands, 3University of Birmingham, Epidemiology and Public Health, Birmingham, United Kingdom, 4Maastricht University Medical Center+, Complex Genetics, Cluster of Genetics and Cell Biology, Maastricht, Netherlands, 5ORBIS Medical Centre, Gastroenterology and Hepatology, Sittard, Netherlands, 6Atrium Medical Center, Internal Medicine and Gastroenterology, Heerlen, Netherlands Background: Population ageing is a worldwide demographic phenomenon. Since the incidence of ulcerative colitis (UC) is increasing, elderly-onset UC will become more prevalent in the near future. It is unclear whether elderly-onset UC is a different phenotypic subgroup, requiring different treatment strategies. Information on disease course and treatment response of elderly-onset UC patients is scarce and conflicting, and often derived from small, selected UC populations. Therefore, we aimed to compare disease course and treatment response between adultand elderly-onset UC in our population-based