Abstract

Diagnosis and Management of Inflammatory Bowel Disease Associated Spondyloarthritis

Am J Gastroenterol. 2024 Sep 23. doi: 10.14309/ajg.0000000000003092. Online ahead of print.

Katherine Falloon 1Michael Forney 2M Elaine Husni 3Brian Feagan 4Florian Rieder 1 5 6

 
     

Author information

1Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland OH, USA.

2Department of Musculoskeletal Radiology, Cleveland Clinic Foundation, Cleveland OH, USA.

3Department of Rheumatologic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland OH, USA.

4Alimentiv, London, ON, Canada; Division of Gastroenterology, Western University, London, ON, Canada.

5Cleveland Clinic Program for Global Translational Inflammatory Bowel Disease (GRID-IBD), Cleveland Clinic, OH, USA.

6Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Abstract

Abstract

Inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA) is common but remains poorly understood. In this review article, we aim to provide guidance regarding the diagnosis and management of this condition. For diagnosis of IBD-associated peripheral SpA (IBD-pSpA), we recommend collaboration with rheumatology for incorporation of clinical symptoms, physical exam findings, joint imaging if applicable, and available diagnostic criteria. For the management of IBD-pSpA, we first recommend assessment and treatment of underlying luminal IBD disease activity. We provide guidance regarding positioning of advanced therapies for IBD in patients with IBD-pSpA based on the limited available literature. For diagnosis of IBD-associated axial SpA (IBD-axSpA), we recommend rheumatology referral to make the diagnosis based on incorporation of symptoms, laboratory data, imaging findings (sacroiilitis) and available diagnostic criteria. For the management of axial SpA, we recommend co-management with rheumatology and use of either anti-tumor necrosis factor agents or janus kinase inhibitors, when applicable.

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