P273 The duration of clinical remission in patients with Crohn's disease depends on the frequency of administration of mesenchymal stromal cells of the bone marrow
Knyazev, O.(1,2,3);Kagramanova, A.V.(1);Lishchinskaya, A.(1);Li, I.(1);Shkurko, T.(2);Veselov, A.(2);Fadeeva, N.(4);Zhulina, E.(4);Parfenov, A.(1);
(1)Moscow Clinical Scientific Center named after A. S. Loginov, Department of IBD, Moscow, Russian Federation;(2)Research Institute of Health Organization and Medical Management, Organization of Coloproctology, Moscow, Russian Federation;(3)State Scientific Centre of Coloproctology named after A.N. Ryzhyh, Department of IBD, Moscow, Russian Federation;(4)Moscow Clinical Scientific Center named after A.S. Loginov, Department of IBD, Moscow, Russian Federation
Background
Anti-cytokine therapy with anti-TNF-α drugs contributes to the achievement of persistent remission of Crohn's disease (CD). Allogeneic mesenchymal stromal cells (MSC) of the bone marrow are also used for the treatment of CD.
Objective: to evaluate the duration of remission of CD in the context of mesenchymal stromal cells (MSC) therapy of the bone marrow, depending on the frequency of MSC administration.
Methods
76 patients with CD with luminal form of CD (terminal ileitis, colitis, and ileocolitis) were divided into two groups. The first group of patients aged 19 to 58 years (Me-29) (n=34) received culture of MCS according to the scheme: 0-1-2-12-26-52 weeks, then annually 2 times a year. The second group of patients with CD (n=42) aged 20 to 62 years (Me-28) received culture of MCS according to the scheme: 0-1-2-12-26-52 weeks to achieve remission within one year. The effectiveness of therapy was evaluated 12, 24, 36, 48 and 60 months after the start of therapy using the Harvey-Bradshaw index.
Results
During 12 months of follow-up, 4/34 patients (11.76%) relapsed among patients in 1-st group. In 2-nd group, relapse occurred in 5/42 (11.9%) (HR-0.63; 95% CI 0.288-3.397; p=0.84).
After 24 months, 6/34 patients (17.6%) relapsed in 1-st group. In the 2-nd group of patients, the disease relapsed in 11/42 (26.2%) (HR-0.674; 95% CI 0.278-1.634; p=0.37).
After 36 months, the disease relapsed in 7/34 patients in 1-st group (20.6%). In the 2-nd group, relapse was in 18/42 (42.8%) (HR-0.48; 95% CI 0.228-1.014; p=0.038).
After 48 months, in the 1-st group receiving MSCS, a relapse occurred in 9/34 (26.5%). In the 2-nd group, relapse occurred in 22/42 (52.4%) (HR-0.5; 95% CI 0.269-0.949; p=0.021).
After 60 months, 10/34 (29.4%) relapsed in 1-st group. In the 2-nd group, relapse occurred in 24/42 (57.1%) (HR-0.463; 95% CI 0.250-0.860; p=0.007).
Conclusion
The duration of clinical remission in patients with luminal Crohn's disease depends on the frequency of administration of mesenchymal stromal cells.