P006 Dependence of the duration of clinical remission in Crohn`s disease from the frequency of introduction of mesenchymal stromal cells

P006
Dependence of the duration of clinical remission in Crohn's disease from the frequency of introduction of mesenchymal stromal cells

Knyazev Oleg1, Kagramanova Anna1, Fadeeva Nina, Babayan Anait1, Lishchinskaya Albina1, Kulakov Dmitriy1, Li Irina1, Zvyaglova Mariya1, Veselov Alexey2, Shkurko Tatyana2, Demchenko Alexandra1, Parfenov Asfold
1 Moscow Clinical Scientific Center named after A. S. Loginov, Moscow, Russia, 2 Research Institute of Health Organization and Medical Management, Moscow, Russia

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 luminal 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 at 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 1st group. In 2nd 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 1st group. In the 2nd 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 1st group (20.6%). In the 2nd 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(S): The duration of clinical remission in patients with luminal CD depends on the frequency of administration of MSC