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Background Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that can lead to complications such as perianal fistulas (PAFs). This study compared disease burden, experiences and health-related quality of life between patients who have CD with PAFs (CPF) and those who have CD without PAFs (non-PAF CD). Methods This cross-sectional, observational study was conducted in three cohorts of US patients aged 18–89 years with self-reported physician-diagnosed CD: (1) non-PAF CD; (2) CPF without PAF-related surgery; and (3) CPF with PAF-related surgery. Data on medical and surgical interventions, CD-specific symptoms and Fecal Incontinence Quality of Life (FIQL) were collected via a web-enabled questionnaire. Statistical comparisons were assessed at the 0.05 level. Results The mean (standard deviation) age of patients in cohorts 1 (n = 300), 2 (n = 51) and 3 (n = 52) was 47 (16.4), 40 (12.2) and 39 (13.1) years, respectively. In patients with CPF (cohort 2 + 3), 59 (57%) reported multiple fistulas and 48 (47%) reported fistula recurrence/persistence. Compared with cohort 1 (non-PAF CD), more patients with CPF reported currently receiving biologic treatment or immunomodulators for CD (58% vs 43% and 23% vs 15%, respectively; both p = 0.01). More patients with CPF also reported undergoing ≥ 1 CD-related surgery and experiencing ≥ 1 failures of CD-related surgery (79% and 20%, respectively) versus cohort 1 (53% and 9%, respectively; both p < 0.001). In cohort 3, 63% of patients had ≥ 3 PAF-related surgeries, and in those receiving seton placement (n = 37), 8% reported placement failure. Post-surgical/seton placement complications were common; the most frequently reported were worsening of pain and swelling around the anus (33%) and fever/infection (29%). CD-specific symptom frequency and severity results indicated a high symptom burden across cohorts; fatigue was reported with the highest frequency and severity. Faecal incontinence (FI) and leakage-related symptoms affected greater proportions of patients in cohorts 2 and 3, often with greater severity and frequency, compared with cohort 1 (Fig.1). Across all cohorts, 58% of patients (cohort 1/2/3, n = 158/35/40) reported experiencing FI and completed the FIQL questionnaire: cohorts 2 and 3 reported lower (worse) FIQL scores across domains than cohort 1 (Fig.2). Conclusion The burden of illness in patients with CPF is substantial, with medical and surgical intervention rates, and symptom severity and frequency greater than for those with non-PAF CD. Higher disease burden, including FI, was noted in patients with CPF compared with the non-PAF CD cohort. An unmet need remains for improved management and outcomes of CPF. Sponsor: Takeda Pharmaceuticals USA, Inc.

publicly insured. PADLI had higher one-year ostomy closure rates (83.3% vs. 64.7%, p<0.01;); p<0.01) and shorter time-to-closure (median 82 days ; p<0.01) relative to HP. PADLI resulted in increased unplanned readmissions (HR¼2.88 ]; p<0.01), and fewer complications upon stoma closure (OR 0.62 [95%CI 0.49-0.78]; p<0.01) but not during the index admission (OR¼1.17 [95%CI 0.96-1.44]; p¼0.12).CONCLUSION: Most patients undergo HP for acute diverticulitis in the U.S. Those who undergo PADLI are more likely to undergo ostomy reversal and experience fewer postoperative complications upon stoma reversal. In agreement with national guidelines, these data support increasing the utilization of PADLI in appropriate cases of acute diverticulitis requiring operative treatment.

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Figure 1. Cardiac event-free Survival in IBD cases vs. non-IBD ControlsTable 1. Demographics by IBD case/control status IBD n553 Non-IBD n5106 P-value Age 55 56 0.97 Female 18 (34%) 34 (32%) 0.81 BMI 28 27 0.99 Race: Caucasian 53 (100% 100 (94%) 0.21 Smoker 14 (26%) 28 (26%) 1 Statin use 22 (42%) 57 (46%) 0.57 Diabetes 5 (9%) 10 (9%) 1 Aspirin Use 9 (17%) 26 (25%) 0.28

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