Background: Enteropathic spondyloarthritis (eSpA) is one of the diseases in the Spondyloarthritis (SpA) spectrum and occurs in patients with inflammatory bowel disease (IBD). Sacroiliitis is frequently found in patients with IBD and can be overlooked because of focusing on IBD.
Objectives: Aim of this study is to evaluate the general features of eSpA and compare with psoriatic spondylitis (PsA), and ankylosing spondylitis (AS).
Methods: HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a prospective, single center database of biological treatments since 2005. eSpA patients were enrolled from HUR-BIO registry. Sacroiliitis was defined as modified New York criteria or based on ASAS magnetic resonance imaging criteria. Age and disease duration matched 128 ankylosing spondylitis and 96 psoriatic spondylitis patients were selected as a control group from HUR-BIO database. Demographic, clinical, laboratory, therapeutic data and imaging features were collected from this database: age, gender, age at disease onset, disease duration, type of IBD. Baseline disease activity before the first biologic therapy use was assessed with BASDAI, BASFI, VAS-patient global assessment, ESR and CRP.
Results: HUR-BIO SpA registry included 2576 SpA patients, and 90 (3.5%) patients had enteropathic arthritis (EA). Sixty four of 90 (71.1%) patients had sacroiliitis according to modified NY criteria, and these patients were included in the study. Of the 64 patients with eSpA, IBD type was ulcerative colitis (UC) in 34 (53%) patients, Crohn’s disease (CD) in 30 (47%) patients. For eSpA patients, initial biological DMARDs were infliximab in 26 (40.6%), adalimumab in 23 (35.9%), etanercept in 10 (15.6%), golimumab in 4 (6.3%), and certolizumab in 1 patient (1.6%). The proportion of bDMARDs were similar with control group. Baseline disease activity were similar between eSpA and control group. However, baseline ESR levels were higher in eSpA than AS (p=0.037) and psoriatic spondylitis (p=0.001), as well. Baseline demographic and clinical features were summarized in Table 1.
Conclusion: Enteropathic spondyloarthrtis was present only a small part of all SpA patients. Sex, SpA family history, and uveitis were different from other SpA subgroups. Disease activities were similar with other spondyloarthritis, but particularly ESR level was higher in eSpA probably due to bowel disease activity. Sacroiliac and spine involvement seems to be the main reason for starting bDMARD in IBD patients, rather than peripheral arthritis.
Data were given as mean (standard deviation) or median (min-max)
HLAB27 were assessed in 27 eSpA, 52 AS and 33 PSA patients.
Disclosure of Interests: Gözde Kübra Yardımcı: None declared, Bayram Farisoğulları: None declared, Alper Sarı: None declared, Levent Kılıç: None declared, Berkan Armagan: None declared, Emre Bilgin: None declared, Ertuğrul Çağrı Bölek: None declared, Omer Karadag: None declared, Ali Akdoğan: None declared, Şule Apraş Bilgen: None declared, Sedat Kiraz: None declared, Ali İhsan Ertenli: None declared, Umut Kalyoncu Grant/research support from: MSD, Roche, UCB, Novartis and Pfizer, Consultant for: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim, Speakers bureau: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim
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