Spondyloarthritis Linked With Higher Disease Activity in Early Crohn Disease

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The presence of human leukocyte antigen B27 (HLA-B27) and higher clinical activity of Crohn disease (CD) are associated with spondyloarthritis (SpA) among patients with early CD, according to a study released during the American College of Rheumatology’s (ACR) annual meeting, ACR Convergence.

“Inflammatory bowel disease, and specifically CD, is known to be associated with SpA,” the researchers wrote. “However, only little is known about factors associated with the development of [SpA] in CD.”

To identify such factors, the researchers focused on the German Spondyloarthritis Inception Cohort’s Crohn disease arm, which included patients recently diagnosed with CD who were either naïve to biological agents or had not been treated with these agents at least 3 months.

Among a total of 108 patients with CD, 21.3% had rheumatologist-diagnosed SpA. In all, 12 patients had axial SpA, and 11 patients had peripheral SpA.

According to the study, HLA-B27 positivity, clinical SpA features (back pain, inflammatory back pain, peripheral arthritis, and enthesitis), higher level of C-reactive protein, and higher CD activity as measured by the Harvey-Bradshaw Index were more common among patients with SpA than among patients without SpA. 

“There were not substantial differences between SpA vs non-SpA patients in terms of CD duration, endoscopic activity, disease location or behavior, or treatment except for mesalamine, which was more frequently administered in patients with SpA than non-SpA (39.1% vs 8.2%, p=0.001, respectively),” the researchers wrote.

—Jolynn Tumolo

Reference:

Rios Rodriguez V, Protopopov M, Proft F, et al. The presence of spondyloarthritis is associated with higher clinical disease activity in patients with early Crohn’s disease: results of a prospective cohort study. Study presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. Accessed November 3, 2020. https://acrabstracts.org/abstract/the-presence-of-spondyloarthritis-is-associated-with-higher-clinical-disease-activity-in-patients-with-early-crohns-disease-results-of-a-prospective-cohort-study/