RT Journal Article
SR Electronic
T1 Impact of gut involvement in patients with high probability of early spondyloarthritis. Data from DESIR cohort.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.181326
DO 10.3899/jrheum.181326
A1 Daniel Wendling
A1 Xavier Guillot
A1 Clément Prati
A1 Corinne Miceli-Richard
A1 Anna Molto
A1 Rik Lories
A1 Maxime Dougados
YR 2019
UL http://www.jrheum.org/content/early/2019/05/24/jrheum.181326.abstract
AB Objective Inflammatory bowel disease (IBD) is a well-known extra articular feature of spondyloarthritis (SpA).The aims of this study were to evaluate in DESIR cohort factors associated with IBD and incidence over 5 years follow-up. Methods DESIR is a prospective observational cohort of patients with recent onset inflammatory back pain suggestive of axial SpA. All available variables in the database were compared between patients with and without IBD at baseline and 5 years, and occurrence over 5 years of follow-up, with uni and then multivariable analysis. Results At baseline, 708 patients, 35 had IBD : prevalence 4.94% [CI 95% : 3.3 – 6.5]. IBD was associated (multivariable) with history of uveitis, levels of DKK-1 and TNF, but not with phenotypic presentation (peripheral arthritis, enthesitis, dactylitis, uveitis) or baseline serum levels of other cytokines. At 5 years, 480 patients were analyzed, 58 with IBD. IBD was associated (multivariable) with fulfillment of modified New York criteria, sick leave, BASDAI, and smoking. No association with MRI scores, enthesitis, psoriasis, BMD. 23 incident cases of IBD were recorded: estimated occurrence rate of 0.95/100 [0.57 – 1.35] patient-years. Incidence of IBD is associated (multivariable) with : HLA B27 : OR 0.36 [0.22 – 0.59], fulfillment of modified New York criteria: OR 3.35 [1.85 – 6.08], familial history of IBD : OR 3.31[1.62 – 6.77] . Conclusion in early SpA, IBD occurs with an incidence of 1/100 patient-years, and is associated with poor outcome, familial history of IBD, absence of HLA-B27, fulfillment of modified New York criteria.