TOPLINE: 

Inflammatory bowel disease (IBD) was present in 13% of patients with axial spondyloarthritis (axSpA). Although those with both axSpA and IBD exhibited clinical features distinct from those with axSpA alone, they had no increased risk for active disease or radiographic progression.

METHODOLOGY:

• Researchers conducted a retrospective analysis of longitudinal data to compare disease characteristics among patients with axSpA with and without IBD and evaluate whether the presence of IBD affected activity and radiographic progression of axSpA.
• They included 1451 patients with axSpA (mean age, 38.4 years; 66% men) seen between May 2003 and December 2021 at an institute in Canada and stratified them into those with IBD (at baseline or who developed it during follow-up) and those with axSpA alone.
• Active disease was defined as having a score of 4 or higher on the Bath Ankylosing Spondylitis Disease Activity Index.
• Radiographic progression was defined as an increase of 2 or more units in the modified Stoke Ankylosing Spondylitis Score over 2 years and was evaluated in patients with available spinal radiographic data.
• Patients were examined every 6-12 months, with an average follow-up duration of 5 years for disease activity and a follow-up of up to 6 years for radiographic progression.

TAKEAWAY:

• Approximately 13% of patients with axSpA had IBD.
• Patients with axSpA and IBD had lower prevalence of human leukocyte antigen B27 (56% vs 76%), higher rates of uveitis (41% vs 32%) and peripheral arthritis (24% vs 17%), and higher levels of C-reactive protein than those with axSpA alone.
• The presence of IBD in patients with axSpA was not associated with active axSpA or its radiographic progression.
• Patients with axSpA and IBD more frequently received conventional synthetic disease-modifying antirheumatic drugs (36% vs 21%) and biologic disease-modifying antirheumatic drugs at baseline (36% vs 25%) than those with axSpA alone.

IN PRACTICE:

"We found that the presence of IBD does not significantly impact axSpA disease activity or radiographic progression in a longitudinal study," the authors of the study write.

SOURCE:

This study was led by Patricia Remalante-Rayco, MD, Schroeder Arthritis Institute, Toronto Western Hospital, Toronto, Canada, and Yassir Daghistani, MBBS, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia. It was published online August 18 in the journal Rheumatology.

LIMITATIONS: 

With few participants having both axSpA and IBD, the study may have been underpowered to detect small but clinically meaningful associations. Data regarding the temporal sequence of axSpA and IBD onset and duration of IBD were lacking. Elevated levels of C-reactive protein observed in patients with both conditions may reflect intestinal rather than musculoskeletal inflammation.

DISCLOSURES:

This study received no specific funding from any agency. Several authors reported receiving grants, consulting fees, research support, and/or serving as speakers for multiple pharmaceutical companies, including AbbVie, Eli Lilly, and Pfizer. See full study for details.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.