Background Crohn's disease (CD) and ulcerative colitis (UC) are the main entities of inflammatory bowel disease (IBD). Both present extraintestinal manifestations that do not always depend on the IBD activity. The most common manifestations involve the musculoskeletal system and they are included in the seronegative spondiloarthritis group. If there is active or known IBD, treatment of this is priority because it usually improves joint disease. However, joint disease can also have an independent course of the intestinal manifestations as in patients with IBD and ankylosing spondylitis (AS).
Objectives To analyze the prevalence of extraintestinal manifestations in IBD patients and treatment provided.
Methods Retrospective observational analysis of IBD patients that have been remitted to the rheumatology department of HUP La Fe with musculoskeletal manifestations. Demographic, clinical and treatment data of patient were collected. Biostatistical analysis with R (3.3.2.) was performed.
Results We recruited 183 patients diagnosed with IBD (57.4% women), 117 with CD and 66 with UC, with a mean age at diagnosis of 37.03±14.02 years old. 29 of them have axial affection and 51 peripheral affection, and simultaneously in 22 cases. We observed no statistical differences in axial or peripheral affection according to the IBD diagnosis. 79 cases were on biological therapy, and these treatments were conducted by Rheumatology in the 44% of cases and by Digestive Department in the 66% of cases. We observed that patients with axial affection present higher probability that the treatment has been conducted by Rheumatology (P=0.007), and broken down axial affections AS diagnosis had the most probability to be conducted by Rheumatology (n=36 P=0.0102). Related to peripheral manifestations, uveitis diagnosis had the most probability to be conducted by Rheumatology (n=14 P=0.0337).
Conclusions In our patient series with IBD and musculoskeletal manifestations, the most common were peripheral affection. Among patients with IBD and axial and/or peripheral manifestation, 44% were conducted by Rheumatology, and are cases with axial predominance, where IBD treatment does not improve musculoskeletal disease and a primary spondyloarthritis treatment is needed.
Disclosure of Interest None declared