6907). There was a higher incidence of extraintestinal manifestations (44%) in patients with HLA B27 compared with those without (25%) (p = 0.0962). Conclusion: The prevalence of HLA B27 in our population of Crohn’s disease is consistent with reports in the literature. Patients with HLA B27 tend to have less severe Crohn’s disease, but there is a higher rate of extraintestinal manifestations. KCP SZE,1,2 A SIRIWARDANA,1,2 A SECHI,1 WSW NG,1,2 SJ CONNOR1,2 1Department of Gastroenterology, Liverpool Hospital, Sydney, New South Wales, Australia, 2The University of New South Wales, Sydney, New South Wales, Australia Background: Thiopurines (TP) are a mainstay selleck kinase inhibitor of inflammatory
bowel disease (IBD) therapy. Thiopurine methyltransferase (TPMT) and TP metabolites testing have been
suggested to predict variation in metabolism and response to therapy. However, prospective data to confirm clinical benefits of metabolites guided dosing is still limited, LY294002 in vivo as are guidelines for TP monitoring. Aim: To evaluate Australian gastroenterologists’ practice in TP use for IBD, including TPMT and metabolites testing, full blood count (FBC) monitoring, allopurinol co-therapy, effects on clinical outcomes, and how practices changed over time. Methods: An anonymous survey was distributed to gastroenterologists by email and at meetings across Australia over 6 months in 2013, and results were compared with a similar survey conducted
in 20081. The Chi-squared and Fisher exact tests were used to calculate statistical significance. Results: 168 responses were received (135 online; 33 paper), of which 137 (81.5%) were complete, while the remainder 31 (18.5%) were partially complete. The results found a statistically significant increase in 2013 from 2008 with respect to the proportion of respondents who utilized TPMT testing (79.1% vs 44.5%, p < 0.0001), and TP metabolites testing (87.7% vs 29.1%, p < 0.0001). A large proportion of those who utilized TP metabolite testing used it not just for non-response (84.8%), but also for dose adjustment to optimize response (80.4%). With respect to allopurinol co-therapy, this was utilized by the majority of respondents (71%) amongst whom a significant proportion used it for MCE shunters irrespective of LFTs (24.7%) or for side effects irrespective of LFTs (36.6%). Overall the majority of respondents believed the availability of metabolites testing had improved clinical outcomes by improved response rates, reduced complication rates, and changed clinical practice (80.6%, 60.4% and 79.2% of respondents, respectively). Additionally, variability was found in full blood count monitoring intervals during the first three months of commencing TP therapy, reflecting a lack of consensus on myelotoxicity monitoring. 1.