Spondyloarthritis Often Diagnosed 5 Years After IBD

Spondyloarthritis in patients with inflammatory bowel disease (IBD) is typically diagnosed after the initial diagnosis of IBD, according to a recent study.

It is well known that spondyloarthritis and peripheral arthritis are among the most common extraintestinal manifestations among patients with IBD. However, less is known about the evaluation of these symptoms.
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For their study, the researchers assessed 626 patients age 18 to 90 years with IBD who had visited a single Veterans Affairs Hospital between 1996 and 2009, of whom 57% had ulcerative colitis (UC). Mean age at diagnosis was 54 years. A total of 90% of patients were men, and 74% were Caucasian.

Patients were identified via International Classification of Diseases, Ninth Revision codes, and IBD diagnosis was confirmed by chart review. Also identified were the presence of ankylosing spondylitis (AS), peripheral arthritis, and other peripheral and axial joint symptoms.

Results indicated that 108 patients (17%) had at least 1 type of joint pain. Of these patients, 12% had AS, 43% had peripheral arthritis, 32% had chronic back pain without AS, and 13% had other types of joint pain.

The researchers noted that the overall incidence of peripheral arthritis (7%) in patients with IBD was 3 times higher than the incidence of AS (2.1%). There were no differences in the incidence of AS or peripheral arthritis in patients with celiac disease or UC. The initial diagnosis of AS typically occurred within a mean of 5.6 years after the initial diagnosis of IBD in 80% of patients.

“Spondyloarthritis among patients with IBD is usually diagnosed after the initial diagnosis of IBD,” the researchers concluded. “No difference in the prevalence of AS or peripheral arthritis was observed by IBD type, age, or race. Recognition and understanding of these results will have important implications for the management of IBD patients with spondyloarthritis.”

—Christina Vogt

Reference:

Malaty HM, Lo GHW, Hou JK. Characterization and prevalence of spondyloarthritis and peripheral arthritis among patients with inflammatory bowel disease [Published online September 27, 2017]. Clin Experimental Gastroenterol. https://doi.org/10.2147/CEG.S136383.