DOP087 Only one third of Crohn's disease patients have sustained remission of perianal fistulas

patients were colonoscoped at 18 months. HRQoL was assessed with a general (SF36) and disease-specific (IBDQ) questionnaire pre-operatively and at 6, 12 and 18 months. CRP, CDAI and faecal calprotectin (FC) were measured longitudinally. Results: 174 patients (median age 38, 55% female) were included. HRQoL was poor pre-operatively: median SF36 = 40 (where maximum=100, Australian normal = 70 90) and IBDQ= 120 (maximum=224, average score in Australian Crohn’s disease patients=156). For all patients both SF36 and IBDQ improved significantly at 6 months to 78 and 178 respectively, and this was sustained at 12 months (81 and 183) and 18 months (80 and 182 respectively). Females had lower HRQoL than males post-op at 6 (SF36 p = 0.012; IBDQ p = 0.007) and 12 months (SF36 p = 0.001, IBDQ p = 0.006). Smokers had poorer HRQoL compared to non-smokers at both 12 and 18 months: SF36 at 12 month p = 0.002, and IBDQ at 12 and 18 months (p = 0.046, p = 0.047 respectively). Persistent endoscopic remission, thiopurine or adalimumab therapy and treatment step up were not associated with changes in HRQoL. There was a significant inverse correlation between CDAI and both SF-36 and IBDQ at 6, 12 and 18 months. HRQoL did not correlate with endoscopic remission, CRP or FC. Conclusions: Intestinal resection of all macroscopic Crohn’s disease, with a focus on maintaining remission, is associated with significant and sustained improvement in general and disease-specific HRQoL. The lower HRQoL in female patients and smokers may reflect partly their lower QoL in the healthy and IBD populations, but this requires further investigation. A higher clinical disease activity index, but not direct measures of active disease or type of drug therapy, is associated with a lower HRQoL, suggesting that symptoms reflect subjective personal factors and not active mucosal disease or drug effects.