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Spondyloarthritis features in IBD patients: prevalence, referral trends and clinical implications. A
Nina Pettersson1, Fredrik Kragbjerg1, Arvid Hamrin2
1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Objectives:
This study examines the prevalence of spondyloarthritis (SpA) features in patients with inflammatory bowel disease (IBD) and their rates of referral to rheumatologists.
Material And Methods:
A questionnaire was administered to 2087 IBD patients (≥18 years) in Sweden, assessing demographics, medications and SpA features based on the ASAS and ESSG classification criteria. Patient that met our self-reported adapted criteria are referred to as suspected SpA.
Results:
Among the 1032 respondents, 59.1% met our questionnaire-based adapted SpA criteria. However, depending on different criteria (based on adapted ASAS, ESSG, peripheral or axial symptoms) only 24.3-44.0% of these patients had been referred to a rheumatologist. Patients with suspected SpA had higher usage of immunomodulators (42.8-48.8% vs. 37.0%), biologics (27.1-32.4% vs. 14.9%) and steroids (58.1-64.8% vs. 46.2%) compared to those without suspected SpA. Additionally, suspected SpA patients reported a higher incidence of active colitis (30.4-40.4% vs. 11.8%). Logistic regression analysis identified significant associations between suspected axial SpA and factors such as age, smoking, psoriasis, anterior uveitis and a high P-SCCAI score (≥5). Female gender and BMI ≥30 kg/m2 were linked to suspected peripheral SpA.
Conclusion:
The study highlights a significant prevalence of self-reported SpA in IBD patients, with many remaining undiagnosed and un-referred to rheumatologists. These findings emphasize the need for greater awareness and improved collaboration between gastroenterologists and rheumatologists for better SpA management in IBD patients.
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