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Screening for spondyloarthritis in patients with inflammatory bowel diseases

  • Observational Research
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Abstract

Inflammatory bowel diseases (IBDs) can be associated with various musculoskeletal (IBD-MSK) manifestations that could be difficult to classify for gastroenterologists. We aimed to evaluate the characteristics of patients with IBD-MSK and the prevalence of spondyloarthritis (SpA). In this observational cross-sectional study, we included patients with IBD-MSK complaints (peripheral or back pain). All patients underwent a standardized rheumatology evaluation including clinical, biological and imaging evaluations (MRI of spine and sacroiliac joints and ultrasonography of enthesis). We included 183 IBD patients (60.7% women; median [interquartile range] age 45 [36–56] years); 159 (87%) had joint pain. In 43 (23.5%) and 25/175 (14.3%) patients, enthesis abnormalities were found on ultrasonography and sacroiliitis on MRI, respectively. SpA was diagnosed in 54 (29.5%) patients. IBD-related arthralgia and degenerative spine disease were diagnosed in 105 (57.4%) and 72 (39.3%) patients. Sixteen (29.6%) SpA patients initiated a new conventional synthetic disease modifying anti-rheumatic drug (DMARD). A biologic DMARD was initiated in 10 patients or changed in 3. More than half of IBD-MSK patients had IBD-related arthralgia, and about one-third had definite SpA. Ultrasonography of enthesis and systematic MRI of sacroiliac joints seem useful for SpA classification and differential diagnosis in these patients who often have musculoskeletal pain complaints. Therapeutics were changed in most patients, which highlights the need for a multidisciplinary approach for managing IBD with extra-intestinal symptoms.

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Acknowledgements

We thank Stephanie Rouanet (StatEthic) for statistical analysis and Laura Smales (BioMedEditing) for copyediting.

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Author notes

  1. Sébastien Ottaviani and Xavier Tréton have contributed equally to this work.

  2. Yoram Bouhnik and Philippe Dieudé have contributed equally to this work.

Authors and Affiliations

  1. Service de Rhumatologie, Université de Paris, Hôpital Bichat, APHP, 46 rue Henri Huchard, 75018, Paris, France

    Sébastien Ottaviani, Marine Forien, Romain Coralli, Astrid Dauchez, Esther Ebstein & Philippe Dieudé

  2. Service de Gastroentérologie, Université de Paris, MICI et Assistance Nutritive, Hôpital Beaujon, APHP, Clichy, France

    Xavier Tréton, Carmen Stefanescu & Yoram Bouhnik

  3. Service de Gastroentérologie, Université de Paris, Hôpital Bichat, APHP, Paris, France

    Anne-Laure Pelletier & Hakim Becheur

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  1. Sébastien Ottaviani
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Contributions

SO, XT, MF, YB, PD were involved in the conception and design of the study, the analysis and interpretation of the data, and the draft and the revision of the manuscript. RC, AD, CS, ALP, HB, MC, LD, JG, EE were involved in the collection of data and revision of manuscript.

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Correspondence to Sébastien Ottaviani.

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Ottaviani, S., Tréton, X., Forien, M. et al. Screening for spondyloarthritis in patients with inflammatory bowel diseases. Rheumatol Int 43, 109–117 (2023). https://doi.org/10.1007/s00296-022-05208-y

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