I. De Vitis

Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents: Effects of combined therapy with immunosuppressants

BACKGROUND AND AIMSnOur first objective was to evaluate the immune response to the adjuvanted 2009 A/H1N1 pandemic (pH1N1) vaccine in inflammatory bowel disease (IBD) patients treated with anti-TNF-α alone or combined with immunosuppressants (IS). Second and third aims were the safety of pH1N1 vaccine and the effects on IBD clinical activity.nnnMETHODSn36 patients with Crohns disease (CD) and 26 with ulcerative colitis (UC) and thirty-one healthy control (HC) subjects were enrolled. 47 patients were on anti TNF-α maintenance monotherapy and 15 on anti TNF-α combined with IS. Sera were collected at baseline (T0) and 4 weeks after the vaccination (T1) for antibody determination by hemagglutination inhibition (HAI). Disease activity was monitored at T0 and T1.nnnRESULTSnSeroprotective titers (≥1:40) in patients were comparable to HC. Seroconvertion rate (≥4 fold increase in HAI titer) was lower than HC in IBD patients (p=0.009), either on anti TNF-α monotherapy (p=0.034) or combined with IS (p=0.011). Geometric mean titer (GMT) of antibodies at T1 was significantly lower in patients on combined therapy versus those on monotherapy (p=0.0017) and versus HC (p=0.011). The factor increase of GMT at T1 versus T0 was significantly lower in IBD patients versus HC (p=0.042), and in those on combined immunosuppression, both versus monotherapy (p=0.0048) and HC (p=0.0015). None of the patients experienced a disease flare.nnnCONCLUSIONnOur study has shown a suboptimal response to pH1N1 vaccine in IBD patients on therapy with anti TNF-α and IS compared to those on anti-TNF-α monotherapy and HC.

Paradoxical psoriasis in a large cohort of patients with inflammatory bowel disease receiving treatment with anti‐TNF alpha: 5‐year follow‐up study

Psoriasis is an emerging paradoxical side effect in patients with inflammatory bowel disease (IBD) when treated with anti‐TNF alpha. Patients with severe skin lesions unresponsive to topical therapy need to withdraw from treatment.

Letter: follow-up practices in coeliac disease--intestinal biopsy after child-to-adult transition might be useful.

1. Mih aly E, Sz ekely H, Hersz enyi L, Wikonk al N, Tulassay Z. Letter: dermatological complications with therapy for inflammatory bowel disease. Aliment Pharmacol Ther 2014; 39: 232–3. 2. Moran GW, Lim AW, Bailey JL, et al. Review article: dermatological complications of immunosuppressive and antiTNF therapy in inflammatory bowel disease. Aliment Pharmacol Ther 2013; 38: 1002–24. 3. Puig L, Morales-M unera CE, L opez-Ferrer A, Geli C. Ustekinumab treatment of TNF antagonist-induced paradoxical psoriasis flare in a patient with psoriatic arthritis: case report and review. Dermatology 2012; 225: 14–7. 4. Andrisani G, Marzo M, Celleno L, et al. Development of psoriasis scalp with alopecia during treatment of Crohn’s disease with infliximab and rapid response to both diseases to ustekinumab. Eur Rev Med Pharmacol Sci 2013; 17: 2831–6. 5. Shale M, Ghosh S. Learning the lessons of anti-tumour necrosis factor therapyassociated psoriasis. Can J Gastroenterol 2009; 23: 674–6. 6. Wenk KS, Claros JM, Ehrlich A. Flare of pustular psoriasis after initiating ustekinumab therapy. J Dermatol Treat 2012; 23: 212–4.

P214 Faecal calprotectin assay after induction with anti-TNF alpha agents in IBD patients: prediction of clinical response and mucosal healing at one year

P214 Faecal calprotectin assay after induction with anti-TNF alpha agents in IBD patients: prediction of clinical response and mucosal healing at one year L. Guidi1 *, M. Marzo1, G. Andrisani1, C. Felice1, D. Pugliese1, I. De Vitis1, A. Papa1, G.L. Rapaccini1, F. Forni2, A. Armuzzi1. 1Internal Medicine and Gastroenterology Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy, 2Clinical Laboratory Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy

P306 Efficacy and safety of low-molecular weight heparin for the prevention of venous thromboembolism in patients with severe ulcerative colitis

P306 Efficacy and safety of low-molecular weight heparin for the prevention of venous thromboembolism in patients with severe ulcerative colitis A. Papa1 *, A. Armuzzi2, L. Guidi3, I. De Vitis4, G. Mocci5, C. Felice4, M. Marzo6, D. Pugliese1, G.L. Rapaccini7. 1Catholic University of Rome, Internal Medicine and Gastroenterology Complesso Integrato Columbus, Rome, Italy, 2Complesso Integrato Columbus, Gastroenterology Unit, Rome, Italy, 3Universita Cattolica Del Sacro Cuore, O.U. Gastroenterology Columbus, Rome, Italy, 4Universita Cattolica Del Sacro Cuore, Complesso integrato Columbus/OU of Internal Medicine and Gastroenterology, Rome, Italy, 5Catholic University of Rome, Internal Medicine Gastroenterology, Rome, Italy, 6Complesso Integrato Columbus, Medicina Interna e Gastroenterologia, Rome, Italy, 7Catholic University of Rome, Complesso Integrato Columbus/OU of Internal Medicine and Gastroenterology, Rome, Italy