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Clinical and patient reported outcomes of the multidisciplinary management in patients with inflammatory bowel disease-associated spondyloarthritis

  • Author Footnotes
    1 These authors contributed equally to this work.
    Michele Maria Luchetti
    Correspondence
    Corresponding author at: Dipartimento di Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy.
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Devis Benfaremo
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Emanuele Bendia
    Affiliations
    Clinica di Gastroenterologia, Università Politecnica delle Marche, 60020 Ancona, Italy

    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Laura Bolognini
    Affiliations
    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Giammarco Fava
    Affiliations
    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Francesco Marini
    Affiliations
    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Antonio Di Sario
    Affiliations
    Clinica di Gastroenterologia, Università Politecnica delle Marche, 60020 Ancona, Italy

    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Monia Ciferri
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Francesca Di Nicola
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Valentina Marconi
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Lucia Perini
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Lucia Manfredi
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Giovanni Pomponio
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
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  • Piergiorgio Mosca
    Affiliations
    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
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  • Author Footnotes
    2 These authors share co-seniorship.
    Antonio Benedetti
    Footnotes
    2 These authors share co-seniorship.
    Affiliations
    Clinica di Gastroenterologia, Università Politecnica delle Marche, 60020 Ancona, Italy

    IBD-UNIT, and Dipartimento Gastroenterologico e dei Trapianti, Polo Ospedaliero-Universitario "Umberto I-G.M. Lancisi- G. Salesi", 60126 Ancona, Italy
    Search for articles by this author
  • Author Footnotes
    2 These authors share co-seniorship.
    Armando Gabrielli
    Footnotes
    2 These authors share co-seniorship.
    Affiliations
    Dipartimento Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, 60020 Ancona, Italy
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    2 These authors share co-seniorship.
Published:April 29, 2019DOI:https://doi.org/10.1016/j.ejim.2019.04.015

      Highlights

      • The presence of a SpA is often overlooked in IBD, with consequent diagnostic delay
      • The early diagnosis may be achieved by a combined gastro-rheumatological clinic
      • The combined clinic improved disease activity and quality of life in SpA/IBD
      • The improvement of disease activity and quality of life lasted up to 2 years
      • The multidisciplinary management of SpA/IBD is effective and feasible in clinical practice

      Abstract

      Objective

      Arthritis is the most frequent extra-intestinal manifestation in patients with inflammatory bowel diseases (IBD). The coexistence of intestinal and articular inflammation advocates the need for a multidisciplinary management of patients with IBD-associated spondyloarthritis.

      Methods

      Consecutive IBD patients were evaluated jointly by the gastroenterologist and the rheumatologist in a combined clinic. All the patients were assessed and screened for articular involvement, disease activity and health related quality of life. After the prescription of a shared treatment, patients with spondyloarthritis were followed up for 24 months.

      Results

      Two hundred sixty-two IBD patients, including 80 who were classified as affected by spondyloarthritis according to the ASAS criteria, were included in the study. At baseline, patients with both IBD and spondyloarthritis showed worse quality of life in both the physical and mental domains. The multidisciplinary management provided a significant improvement of gastrointestinal and articular manifestations, as well as the health-related quality of life. Moreover, global and gastrointestinal-specific quality of life significantly correlated with articular disease activity.

      Conclusion

      The multidisciplinary management significantly improves both articular and gastrointestinal disease activities and the quality of life of patients with IBD-associated spondyloarthritis.
      An appropriate screening strategy and the integrated management of these patients should be encouraged and employed in clinical practice.

      Keywords

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