https://doi.org/10.4081/reumatismo.2024.1688
The holistic management of peripheral spondyloarthritis: focus on articular involvement in patients with inflammatory bowel disease
Submitted: 2 December 2023
Accepted: 11 July 2024
Published: 11 November 2024
Accepted: 11 July 2024
Abstract Views: 137
PDF: 67
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective. To provide a comprehensive overview of peripheral spondyloarthritis (pSpA), focusing specifically on its occurrence and management in patients with inflammatory bowel disease (IBD).
Methods. An exhaustive literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, and Google Scholar to identify relevant studies on pSpA in IBD patients. Titles, abstracts, and full-text articles were screened for relevance. Data on study design, patient characteristics, diagnostic criteria, main findings, and conclusions were extracted from selected articles. Study quality was assessed using appropriate checklists. Information was synthesized narratively to summarize current understanding.
Results. pSpA is the most common extraintestinal manifestation in IBD, with a median prevalence of 16%. It worsens quality of life and requires collaboration between gastroenterologists and rheumatologists for optimal diagnosis and treatment. Several “red flags” guide appropriate specialist referral of IBD patients with suspected pSpA. Once the diagnosis is confirmed, the choice of therapy depends on IBD phenotype and patterns of articular/axial involvement. Anti-tumor necrosis factor (TNF) drugs are first-line biologics, with interleukin (IL)-12/23 and IL-23 inhibitors as alternatives for anti-TNF failure. Small molecules like apremilast and Janus kinase inhibitors also have utility. Recommended treatment algorithms exist, but more randomized controlled trials are needed.
Conclusions. Early identification of pSpA is crucial in IBD patients to enable timely intervention, prevent structural damage, and minimize disability. A multidisciplinary, holistic approach addressing musculoskeletal and extra-musculoskeletal manifestations is key to optimal patient outcomes.
Dougados M, Baeten D. Spondyloarthritis. Lancet 2011; 377: 2127-37.
DOI: https://doi.org/10.1016/S0140-6736(11)60071-8
Carron P, De Craemer AS, Van den Bosch F. Peripheral spondyloarthritis: a neglected entity -state of the art. RMD Open 2020; 6: e001136.
DOI: https://doi.org/10.1136/rmdopen-2019-001136
Scriffignano S, Perrotta FM, De Socio A, Lubrano E. Role of comorbidities in spondyloarthritis including psoriatic arthritis. Clin Rheumatol 2019; 38: 3-10.
DOI: https://doi.org/10.1007/s10067-018-4332-7
Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-73.
DOI: https://doi.org/10.1002/art.21972
Fornaro M, Righetti G, Abbruzzese A, Lopalco G, Cacciapaglia F, Anelli MG, et al. High disease relapse after BDMARD spacing in psoriatic arthritis compared to rheumatoid arthritis and axial spondyloarthritis patients: real-life data from BIOPURE registry. Clin Rheumatol 2021; 40: 3659-65.
DOI: https://doi.org/10.1007/s10067-021-05728-1
Venerito V, Natuzzi D, Bizzoca R, Lacarpia N, Cacciapaglia F, Lopalco G, et al. Serum SCD40L levels are increased in patients with psoriatic arthritis and are associated with clinical response to apremilast. Clin Exp Immunol 2020; 201: 200-4.
DOI: https://doi.org/10.1111/cei.13451
Iannone F, Nivuori M, Fornaro M, Venerito V, Cacciapaglia F, Lopalco G. Comorbid fibromyalgia impairs the effectiveness of biologic drugs in patients with psoriatic arthritis. Rheumatology 2020; 59: 1599-606.
DOI: https://doi.org/10.1093/rheumatology/kez505
Ziade N, Bou Absi M, Baraliakos X. Peripheral spondyloarthritis and psoriatic arthritis sine psoriase: are we dealing with semantics or clinically meaningful differences? RMD Open 2022; 8: e002592.
DOI: https://doi.org/10.1136/rmdopen-2022-002592
López-Medina C, Moltó A, Dougados M. Peripheral manifestations in spondyloarthritis and their effect: an ancillary analysis of the ASAS-COMOSPA study. J Rheumatol 2020; 47: 211-7.
DOI: https://doi.org/10.3899/jrheum.181331
Arevalo Salaet M, López-Medina C, Moreno M, Navarro-Compan V, Calvet Fontova J, Llop M, et al. Association between HLA-B27 and peripheral spondyloarthritis phenotype: results from the ASAS PerSpA study. RMD Open 2022; 8: e002696.
DOI: https://doi.org/10.1136/rmdopen-2022-002696
Nash P, Mease PJ, Braun J, van der Heijde D. Seronegative spondyloarthropathies: to lump or split? Ann Rheum Dis 2005; 64: ii9-13.
DOI: https://doi.org/10.1136/ard.2004.033654
Smolen JS, Braun J, Dougados M, Emery P, Fitzgerald O, Helliwell P, et al. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis 2014; 73: 6-16.
DOI: https://doi.org/10.1136/annrheumdis-2013-203419
Lubrano E, Scriffignano S, De Socio A, Perrotta FM. Analysis of potential determinants for a treat-to-target strategy in psoriatic arthritis patients from a real-world setting. Clin Exp Rheumatol 2019; 37: 512.
Novelli L, Lubrano E, Venerito V, Perrotta FM, Marando F, Curradi G. et al. Extra-articular manifestations and comorbidities in psoriatic disease: a journey into the immunologic crosstalk. Front Med 2021; 8: 737079.
DOI: https://doi.org/10.3389/fmed.2021.737079
Venerito V, Lopalco G, Abbruzzese A, Colella S, Morrone M, Tangaro S, et al. A machine learning approach to predict remission in patients with psoriatic arthritis on treatment with secukinumab. Front Immunol 2022; 13: 917939.
DOI: https://doi.org/10.3389/fimmu.2022.917939
Lubrano E, Scriffignano S, Azuaga AB, Ramirez J, Cañete JD, Perrotta FM. Assessment of the patient acceptable symptom state (PASS) in psoriatic arthritis: association with disease activity and quality of life indices. RMD Open 2020; 6: e001170.
DOI: https://doi.org/10.1136/rmdopen-2020-001170
Gossec L, de Wit M, Kiltz U, Braun J, Kalyoncu U, Scrivo R, et al. A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the psoriatic arthritis impact of disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 2014; 73: 1012-9.
DOI: https://doi.org/10.1136/annrheumdis-2014-205207
Mease P, Sieper J, Van den Bosch F, Rahman P, Karunaratne PM, Pangan AL. Randomized controlled trial of adalimumab in patients with nonpsoriatic peripheral spondyloarthritis. Arthritis Rheumatol 2015; 67: 914-23.
DOI: https://doi.org/10.1002/art.39008
Coates LC, Soriano ER, Corp N, Bertheussen H, Callis Duffin K, Campanholo CB, Chau J, et al. Group for research and assessment of psoriasis and psoriatic arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol 2022; 18: 465-79.
DOI: https://doi.org/10.1038/s41584-022-00798-0
Gossec L, Baraliakos X, Kerschbaumer A, de Wit M, McInnes I, Dougados M, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020; 79: 700-12.
DOI: https://doi.org/10.1136/annrheumdis-2020-217163
Carron P, Varkas G, Cypers H, Praet LV, Elewaut D, den Bosch FV. Anti-TNF-induced remission in very early peripheral spondyloarthritis: the CRESPA study. Ann Rheum Dis 2017; 76: 1389-95.
DOI: https://doi.org/10.1136/annrheumdis-2016-210775
Ramonda, R.; Lorenzin, M.; Carriero, A.; Chimenti, M.S.; Scarpa, R.; Marchesoni, A. et al. Effectiveness and Safety of Secukinumab in 608 Patients with Psoriatic Arthritis in Real Life: A 24-Month Prospective, Multicentre Study. RMD Open 2021, 7, e001519, doi:10.1136/rmdopen-2020-001519.
DOI: https://doi.org/10.1136/rmdopen-2020-001519
Ramonda R, Lorenzin M, Chimenti MS, D’Angelo S, Marchesoni A, Salvarani C, et al. Effectiveness and safety of secukinumab in axial spondyloarthritis: a 24-month prospective, multicenter real-life study. Ther Adv Musculoskelet Dis 2022; 14: 1759720X221090310.
DOI: https://doi.org/10.1177/1759720X221090310
de Hooge M, Ramonda R, Lorenzin M, Frallonardo P, Punzi L, Ortolan A, et al. Work productivity is associated with disease activity and functional ability in Italian patients with early axial spondyloarthritis: an observational study from the SPACE cohort. Arthritis Res Ther 2016; 18: 265.
DOI: https://doi.org/10.1186/s13075-016-1162-3
Ortolan A, Lorenzin M, Leo G, Pampaloni F, Messina F, Doria A, et al. Secukinumab drug survival in psoriasis and psoriatic arthritis patients: a 24-month real-life study. Dermatology 2022; 238: 1-7.
DOI: https://doi.org/10.1159/000522008
Lubrano E, Scriffignano S, Azuaga AB, Ramirez J, Cañete JD, Perrotta FM. Impact of comorbidities on disease activity, patient global assessment, and function in psoriatic arthritis: a cross-sectional study. Rheumatol Ther 2020; 7: 825-36.
DOI: https://doi.org/10.1007/s40744-020-00229-0
Benavent D, Capelusnik D, Ramiro S, Molto A, López-Medina C, Dougados M, et al. Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASAS-PerSpA study. RMD Open 2022; 8: e002514.
DOI: https://doi.org/10.1136/rmdopen-2022-002514
Schwartzman M, Ermann J, Kuhn KA, Schwartzman S, Weisman MH. Spondyloarthritis in inflammatory bowel disease cohorts: systematic literature review and critical appraisal of study designs. RMD Open 2022; 8: e001777.
DOI: https://doi.org/10.1136/rmdopen-2021-001777
Laganà B, Zullo A, Scribano ML, Chimenti MS, Migliore A, Picchianti Diamanti A, et al. Sex differences in response to TNF-inhibiting drugs in patients with spondyloarthropathies or inflammatory bowel diseases. Front Pharmacol 2019; 10: 47.
DOI: https://doi.org/10.3389/fphar.2019.00047
Greuter T, Manser C, Pittet V, Vavricka SR, Biedermann L. Gender differences in inflammatory bowel disease. Digestion 2020; 101: 98-104.
DOI: https://doi.org/10.1159/000504701
van der Have M, Brakenhoff LKPM, van Erp SJH, Kaptein AA, Leenders M, Scharloo M, et al. Back/joint pain, illness perceptions and coping are important predictors of quality of life and work productivity in patients with inflammatory bowel disease: a 12-month longitudinal study. J Crohns Colitis 2015; 9: 276-83.
DOI: https://doi.org/10.1093/ecco-jcc/jju025
Felice C, Leccese P, Scudeller L, Lubrano E, Cantini F, Castiglione F, et al. Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis. Clin Exp Immunol 2019; 196: 123-38.
DOI: https://doi.org/10.1111/cei.13246
Olivieri I, Cantini F, Castiglione F, Felice C, Gionchetti P, Orlando A, et al. Italian expert panel on the management of patients with coexisting spondyloarthritis and inflammatory bowel disease. Autoimmun Rev 2014; 13: 822-30.
DOI: https://doi.org/10.1016/j.autrev.2014.04.003
Armuzzi A, Felice C, Lubrano E, Cantini F, Castiglione F, Gionchetti P, et al. Multidisciplinary management of patients with coexisting inflammatory bowel disease and spondyloarthritis: a delphi consensus among Italian experts. Dig Liver Dis 2017; 49: 1298-305.
DOI: https://doi.org/10.1016/j.dld.2017.06.004
Sandborn WJ, Feagan BG, Stoinov S, Honiball PJ, Rutgeerts P, Mason D, et al. Certolizumab pegol for the treatment of Crohn's disease. N Engl J Med 2007; 357: 228-38.
DOI: https://doi.org/10.1056/NEJMoa067594
Schreiber S, Khaliq-Kareemi M, Lawrance IC, Thomsen OØ, Hanauer SB, McColm J, et al. Maintenance therapy with certolizumab pegol for Crohn's disease. N Engl J Med 2007; 357: 239-50.
DOI: https://doi.org/10.1056/NEJMoa062897
Felice C, Pugliese D, Papparella LG, Pizzolante F, Onori E, Gasbarrini A, et al. Clinical management of rheumatologic conditions co-occurring with inflammatory bowel diseases. Expert Rev Clin Immunol 2018; 14: 751-9.
DOI: https://doi.org/10.1080/1744666X.2018.1513329
Sandborn WJ, Stenson WF, Brynskov J, Lorenz RG, Steidle GM, Robbins JL, et al. Safety of celecoxib in patients with ulcerative colitis in remission: a randomized, placebo-controlled, pilot study. Clin Gastroenterol Hepatol 2006: 4; 203-11.
DOI: https://doi.org/10.1016/j.cgh.2005.12.002
El Miedany Y, Youssef S, Ahmed I, El Gaafary M. The gastrointestinal safety and effect on disease activity of etoricoxib, a selective Cox-2 inhibitor in inflammatory bowel diseases. Am J Gastroenterol 2006; 101: 311-7.
DOI: https://doi.org/10.1111/j.1572-0241.2006.00384.x
Jang D, Lee AH, Shin HY, Song HR, Park JH, Kang TB, et al. The role of tumor necrosis factor alpha (TNF-α) in autoimmune disease and current TNF-α inhibitors in therapeutics. Int J Mol Sci 2021; 22: 2719.
DOI: https://doi.org/10.3390/ijms22052719
Roberts J, O’Rielly DD, Rahman P. A review of ustekinumab in the treatment of psoriatic arthritis. Immunotherapy 2018; 10: 361-72.
DOI: https://doi.org/10.2217/imt-2017-0149
Mease PJ, McInnes IB, Tam LS, Eaton K, Peterson S, Schubert A, et al. Comparative effectiveness of guselkumab in psoriatic arthritis: results from systematic literature review and network meta-analysis. Rheumatology 2021; 60: 2109-21.
DOI: https://doi.org/10.1093/rheumatology/keab119
Conigliaro P, D’Antonio A, Wlderk A, Sabuzi F, Ferraioli M, Sichi L, et al. Clinical and imaging findings in enteropathic spondyloarthritis with special emphasize in diagnostic delay: a cross-sectional study. Ther Adv Chronic Dis 2024; 15: 20406223241229843.
DOI: https://doi.org/10.1177/20406223241229843
Fatica M, Monosi B, Conigliaro P, D’Antonio A, Essofi S, Cuccagna E, et al. Impact of biological therapy in reducing the risk of arthritis development in inflammatory bowel diseases. RMD Open 2024; 10: e003820.
DOI: https://doi.org/10.1136/rmdopen-2023-003820
Conigliaro P, Chimenti MS, Triggianese P, D’Antonio A, Sena G, Alfieri N, et al. Two years follow-up of golimumab treatment in refractory enteropathic spondyloarthritis patients with Crohn disease. Medicine 2021; 100: e25122.
DOI: https://doi.org/10.1097/MD.0000000000025122
Conigliaro P, Chimenti MS, Ascolani M, Triggianese P, Novelli L, Onali S, et al. Impact of a multidisciplinary approach in enteropathic spondyloarthritis patients. Autoimmun Rev 2016; 15: 184-90.
DOI: https://doi.org/10.1016/j.autrev.2015.11.002
Kristensen LE, Keiserman M, Papp K, McCasland L, White D, Lu W, et al. Efficacy and safety of risankizumab for active psoriatic arthritis: 24-week results from the randomised, double-blind, phase 3 KEEPsAKE 1 trial. Ann Rheum Dis 2022; 81: 225-31.
DOI: https://doi.org/10.1136/annrheumdis-2021-221019
Fragoulis GE, McInnes IB, Siebert S. JAK-inhibitors. New players in the field of immune-mediated diseases, beyond rheumatoid arthritis. Rheumatology 2019; 58: i43-54.
DOI: https://doi.org/10.1093/rheumatology/key276
Furer V, Rondaan C, Heijstek MW, Agmon-Levin N, van Assen S, Bijl M, et al. 2019 Update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2020; 79: 39-52.
DOI: https://doi.org/10.1136/annrheumdis-2019-215882
How to Cite
Lubrano, E., Armuzzi, A., Scriffignano, S., Felice, C., Perrotta, F., Venerito, V., … Favalli, E. (2024). The holistic management of peripheral spondyloarthritis: focus on articular involvement in patients with inflammatory bowel disease. Reumatismo. https://doi.org/10.4081/reumatismo.2024.1688
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- S. Scriffignano, F.M. Perrotta, M. Ricci, B. Carabellese, E. Lubrano , Visceral muscle dysmotility syndrome in systemic lupus erythematosus: which is the role of 18 fluorodeoxyglucose-positron emission tomography-computed tomography? A clinical case and literature review , Reumatismo: Early Access
- M. Skoczynska, F. Figus, V. Arena, G. Massazza, A. Iagnocco, The role of PET in a clinically silent and ultrasound negative synovitis in the course of rheumatoid arthritis - a case report , Reumatismo: Vol. 73 No. 1 (2021)
- F. Oliviero, R. Ramonda, A. Hoxha, A. Scanu, P. Galozzi, M. Favero, P. Frallonardo, L. Punzi, Effect of an oral preparation containing hyaluronic acid, chondroitin sulfate, hydrolyzed collagen type II and hydrolyzed keratin on synovial fluid features and clinical indices in knee osteoarthritis. A pilot study , Reumatismo: Vol. 72 No. 3 (2020)
- C.S.R. Araujo, A.M. dos Santos, P.A. Olivo Pallo, R.M.R. Pereira, S.K. Shinjo, Is there a reliable association between patient-reported limb claudication and vascular imaging methods in Takayasu arteritis? , Reumatismo: Vol. 72 No. 2 (2020)
- J.S. Arakaki, F. Jennings, G.Q. Estrela, V.d.G. Cruz Martinelli, J. Natour, Strengthening exercises using swiss ball improve pain, health status, quality of life and muscle strength in patients with fibromyalgia: a randomized controlled trial , Reumatismo: Vol. 73 No. 1 (2021)
- P. Falsetti, E. Conticini, C. Baldi, C. Acciai, R. D'Alessandro, M. Bardelli, L. Cantarini, B. Frediani, Observations about subcalcaneal adventitial bursitis (heel fat pad inflammatory lesion) in rheumatoid arthritis. Comment on the article of Suzuki and Shirai , Reumatismo: Vol. 72 No. 3 (2020)
- H. Beyaztas, S. Aktas, E.M. Guler, E. Ata, Oxidative stress may be a contributing factor in fibromyalgia patients’ pain mechanisms , Reumatismo: Vol. 75 No. 3 (2023)
- F. Masini, K. Gjeloshi, E. Pinotti, R. Ferrara, C. Romano, G. Cuomo, Polymyositis following varicella and mumps infection in adults: report of two cases , Reumatismo: Vol. 75 No. 4 (2023)
You may also start an advanced similarity search for this article.
