Review
Enteropathic spondyloarthritis: Results from a large nationwide database analysis

https://doi.org/10.1016/j.autrev.2019.102457Get rights and content
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Abstract

Introduction

Spondyloarthrits (SpA) share clinical, genetic and immunological features with Inflammatory Bowel Diseases (IBD), and enteropathic SpA (eSpA) represent the clinical evidence of the association between gut and joint diseases.

This cross-sectional study aimed to report data of eSpA patients collected from the first Italian database.

Patients and methods

A specific web-based interface has been created to insert and collect the main clinical, serologic and imaging data from patients with eSpA, as well as disease activity, comorbidities and treatment, in a real-life scenario.

Results

Data were collected in 14 Italian centers (7 rheumatology and 7 gastroenterology units). A total of 347 eSpA patients were enrolled in the study. Type 1 peripheral eSpA was the most frequent form. Crohn’ Disease (CD) was the most represented IBD. CD activity was similar among eSpA, whereas UC activity was slightly higher in the axial and mixed form than in the peripheral eSpA. The disease was active in less than half of axial eSpA patients and in only 18% of patients with peripheral eSpA. Furthermore, most of the patients had an inactive IBD. Nineteen percent of the total eSpA patients were free of therapy at the time of the enrollment and 61% of the patients were receiving biotechnological agents.

Conclusions

The multidisciplinary management of eSpA patients, favored by this ad hoc created web-based platform, allowed to obtain data from the largest eSpA cohort. The information coming of this database might advance knowledge of eSpA and improve their standard of care.

Keywords

Enteropathic spondyloarthritis
Inflammatory bowel diseases
Axial SpA
Peripheral SpA
Crohn's disease
Ulcerative colitis
Disease activity
Anti-TNF-alpha

Abbreviations

SpA
Spondyloarthritis
eSpA
enteropathic SpA
IBD
Inflammatory Bowel Diseases
CD
Crohn's Disease
UC
Ulcerative Colitis
PsA
Psoriatic Arthritis
SIGR
Società Italiana di GastroReumatologia
ESR
erythrocyte sedimentation rate
CRP
C-reactive protein
MRI
magnetic resonance imaging
ASDAS
Ankylosing Spondylitis Disease Activity Score
BASDAI
Bath Ankylosing Spondylitis Disease Activity Index
BASFI
Bath Ankylosing Spondylitis Functional Index
LEI
Leeds enthesitis index
HAQ-S
Health Assessment Questionnaire for SpA
HBI
Harvey-Bradshaw Index
csDMARDs
conventional DMARDS
bDMARDs
biotechnological DMARDs
SSA
sulphasalazine
MTX
methotrexate
AZA
azathioprine
CSA
cyclosporine

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1

these authors contributed equally to the manuscript.