P496 Antenatal thiopurine exposure in women with IBD is associated with intrahepatic cholestasis of pregnancy

Abstract Background Pregnant women with Inflammatory Bowel Disease (IBD) continue thiopurines to maintain remission. Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder pregnancy, often causing distressing maternal symptoms and potential implications for outcome. Case studies have reported treatment-resistant intrahepatic in thiopurine-exposed IBD pregnancies. We aimed investigate whether are associated an increased risk ICP course setting thiopurine therapy. Methods Single-centre retrospective cohort study comparing incidence exposed vs non-exposed patients compared age-matched pregnant controls. Results The consisted 386 pregnancies 243 IBD, controls without IBD. In was more amongst (n=10 9.0% n=5 1.8%; OR 5.34 [1.78-16.02]; p=0.021). Only exposure development ICP. Age, disease activity, phenotype, previous surgery, mesalazine, biologic, steroid were not associated. All cases (of which 4 received ursodeoxycholic acid) improved symptomatically discontinuation. significantly lower (n=5 1.3% n=15 4.1%; p=0.039). Thiopurine-exposed had higher odds experiencing non-IBD (n= 10 1.3%; 7.55 [2.52-22.57]; p<0.001). a comparable (n-=5 1.8% p=0.75). Severe (total serum bile acids ≥40 µmol/l) occurred 80% patients, 40% (p=0.25), 20% (p=0.09). found no evidence unfavourable cases. Median week delivery different among all three groups (p=0.39). Conclusion Thiopurine general population Clinicians involved management should be aware assess when occur. Prospective required understand relationship between metabolites