Abstract
Background
Spondyloarthritis (SpA) is one of the most common extraintestinal manifestations of
inflammatory bowel disease (IBD). Diagnostic delay must be avoided.
Aims
We assessed the validity of SpA screening criteria (any of the following characteristics:
chronic low back pain with onset before 45 years of age; inflammatory lower back pain
or alternating buttock pain; arthritis; heel enthesitis; dacylitis; HLA-B27 positivity;
sacroiliitis on imaging).
Methods
This was a multicenter cross-sectional observational study in IBD patients aged ≥18
years. After evaluating the SpA screening criteria, the gastroenterologists referred
the participants to the rheumatologists, who determined whether the patient fulfilled
the screening criteria and carried out the necessary tests for SpA diagnosis.
Results
35 (11.7%) out of 300 patients were diagnosed with SpA. The combination with the best
balance between sensitivity and specificity (91.4% and 72.1%, respectively, when applied
by the rheumatologists; 80% and 78.9%, when applied by the gastroenterologists) for
SpA screening, was fulfillment of any of the following: chronic low back pain with
onset before age 45 years, inflammatory low back pain or alternating buttock pain,
arthritis, or dactylitis.
Conclusion
This is one of the first studies to validate SpA screening criteria in IBD patients
in routine clinical practice.
Keywords
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References
- Extraintestinal manifestations in patients with inflammatory bowel disease: study based on the ENEIDA Registry.Dig Dis Sci. 2020; https://doi.org/10.1007/s10620-020-06424-x
- Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease.World J Gastroenterol. 2009; 15: 2449-2455
- Management of arthropathy in inflammatory bowel diseases.Ther Adv Chronic Dis. 2015; 6: 65-77
- Enteropathic spondyloarthritis: from diagnosis to treatment.Clin Dev Immunol. 2013; https://doi.org/10.1155/2013/631408
- Consensus statement of the Spanish society of rheumatology on the management of biologic therapies in spondyloarthritis except for psoriatic arthritis.Reumatol Clin. 2011; 7: 113-123
- Musculoskeletal manifestations in a population based cohort of inflammatory bowel disease patients.Scand J Gastroenterol. 2001; 36: 1307-1313
- Inflammatory articular disease in patients with inflammatory bowel disease: result of the Swiss IBD Cohort Study.Inflamm Bowel Dis. 2015; 21: 2598-2604
- Ultrasonographic and clinical assessment of peripheral enthesitis and arthritis in an Italian cohort of inflammatory bowel disease patients.Semin Arthritis Rheum. 2020; 50: 436-443
- The prevalence and incidence of axial and peripheral spondyloarthritis in inflammatory bowel disease: a systematic review and metaanalysis.J Crohns Colitis. 2017; 11: 631-642
- Arthritis and inflammatory bowel disease.Curr Rheumatol Rep. 2000; 2: 87-88
- Impact of a multidisciplinary approach in enteropathic spondyloarthritis patients.Autoimmun Rev. 2016; 15: 184-190
- Prevalence of spondyloarthritis in Turkish patients with inflammatory bowel disease.Rheumatol Int. 2009; 29: 955-957
- Delayed diagnosis is linked to worse outcomes and unfavourable treatment responses in patients with axial spondyloarthritis.Clin Rheumatol. 2015; 34: 1397-1405
- The window of opportunity: a relevant concept for axial spondyloarthritis.Arthritis Res Ther. 2014; 16: 109
- Spondyloarthritis: a window of opportunity?.Joint Bone Spine. 2014; 81: 197-199
- Clinical and patient reported outcomes of the multidisciplinary management in patients with inflammatory bowel disease-associated spondyloarthritis.Eur J Intern Med. 2019; 64: 76-84
- Screening of Inflammatory Bowel Disease and Spondyloarthritis for Referring Patients Between Rheumatology and Gastroenterology.Reumatol Clin. 2018; 14: 68-74
- Towards an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of gastroenterology.Can J Gastroenterol. 2005; 19: 5-36
- A simple index of Crohn's-disease activity.Lancet. 1980; 1: 514
- A systematic prospective comparison of noninvasive disease activity indices in ulcerative colitis.Clin Gastroenterol Hepatol. 2009; 7: 1081-1088
- Can endoscopy be avoided in the assessment of ulcerative colitis in clinical trials?.Inflamm Bowel Dis. 2012; 18: 2056-2062
- New approaches to diagnosis and classification of axial and peripheral spondyloarthritis.Curr Opin Rheumatol. 2010; 22: 375-380
- Clinical management of the most common extra-intestinal manifestations in patients with inflammatory bowel disease focused on the joints, skin and eyes.United European Gastroenterol J. 2020; 8: 1031-1044
- Low back pain and sacroiliitis on cross-sectional abdominal imaging for axial spondyloarthritis diagnosis in inflammatory bowel diseases.Inflamm Intest Dis. 2020; 5: 124-131
- Subclinical sacroiliitis detected by abdominopelvic computed tomography in Korean patients with Crohn's disease.Korean J Intern Med. 2021; https://doi.org/10.3904/kjim.2020.199
- The DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire: development and preliminary testing of a new tool to screen patients with inflammatory bowel disease for the presence of spondyloarthritis.Clin Rheumatol. 2018; 37: 1037-1044
- Multicenter validation of the DETAIL Questionnaire for the screening of spondyloarthritis in patients with inflammatory bowel diseases.J Rheumatol. 2021; 48: 179-187
- Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis.Clin Exp Immunol. 2019; 196: 123-138
- Risk factors of suspected spondyloarthritis among inflammatory bowel disease patients.Scand J Gastroenterol. 2019; 54: 1233-1236
- The IBIS-Q (IBd Identification of Spondyloarthrytis Questionnaire): a novel tool to detect both axial and peripheral arthritis in inflammatory bowel disease patients.J Crohns Colitis. 2020; https://doi.org/10.1093/ecco-jcc/jjaa096
- Expert consensus: practical algorithms for management of inflammatory bowel disease patients presenting with back pain or peripheral arthropathies.Aliment Pharmacol Ther. 2019; 50: 1204-1213
- Editorial: establishing a joint approach to a common problem for gastroenterologists.Aliment Pharmacol Ther. 2020; 51: 306-307
Article info
Publication history
Published online: January 14, 2022
Accepted:
December 14,
2021
Received:
October 20,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
