P97 Evaluation of a dedicated clinic for patients with primary sclerosing cholangitis provided by hepatology and inflammatory bowel disease physicians

<h3></h3> Primary sclerosing cholangitis (PSC) is a rare immune-mediated cholestatic liver disease strongly associated with inflammatory bowel disease (IBD). The condition is associated with risks of liver complications and an increased risk of both hepatobiliary and colorectal malignancy. A previous audit in our region in 2021 demonstrated as many as 76% of patients did not have up to date colonoscopic surveillance. In March 2024, we established a dedicated PSC clinic led by Hepatologists with regular input from PSC interested IBD physicians. We summarise a cross-sectional analysis of patients attending the clinic after one year and audit of current practice in the clinic. This service evaluation included all patients with PSC referred to the PSC clinic between March 2024 and March 2025. Electronic patient records were reviewed to record variables including age, sex, date of diagnosis, presence of large or small duct disease, presence of IBD, presence of cirrhosis, history of surgery, date of last colonoscopy, and date of last MRCP. 48 patients attended the clinic. 34 (71%) were male. Median age was 42.5 years. 3/48 (6%) patients in the clinic had small duct disease. 39/45 (87%) of patients with large duct disease had an MRCP in the previous 12 months. 35/48 (73%) of patients had IBD. 25/35 (71%) were ulcerative colitis and 8/35 (23%) were Crohn’s disease. 9/35 (26%) patients had previous colonic surgery. Of these, 3 patients had an ileoanal pouch and 1 patient a rectal stump. 21/28 (75%) patients with both PSC-IBD and an intact colon had a colonoscopy done in the previous 12 months. 26/44 (59%) of colonoscopies were performed by IBD consultants. 1/6 (17%) patients with residual colorectal mucosa post-surgery had a colonoscopy/pouchoscopy performed in the previous 12 months. However, stump inspection or pouchoscopy had been requested for these patients and non-attendance was a factor for those not performed. 10/48 (21%) patients had cirrhosis. The baseline characteristics of the study population appear in line with those of larger cohort studies of patients with PSC. We have found in our centre that establishing a dedicated PSC clinic by a small number of PSC interested Hepatologists and IBD physicians has aligned our surveillance practice more compliantly with current PSC guidelines. Going forward, we hope the clinic can serve as a base for ongoing audits of best practices in patients with PSC and improve access to forthcoming trials for patients with PSC in our region.