Study confirms high prevalence of bowel inflammation in psoriatic arthritis and spondyloarthritis

According to a recent study by the Spanish Rheumatology Foundation and the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU), intestinal inflammation plays a very important role in the development of axial spondyloarthritis and psoriatic arthritis. APS that show high levels of calprotectin, suggesting subclinical inflammatory bowel disease,” explains Dr. Jesús Sanz from the Rheumatology Service of the Puerta de Hierro Majadahonda University Hospital in Madrid and principal investigator together with Dr. Ana Gutiérrez Casbas from the EISER Project.

“Many of these patients end up with some form of inflammatory bowel disease, mainly Crohn’s disease, and this greatly impacts both their treatment and prognosis. Identifying it at an early stage is very useful, since we can somehow avoid the course of the disease and the consequences it can cause in our patients,” states the specialist.

In the case of axial spondyloarthritis, Dr. Sanz said the study’s results were as expected, revealing a large number (6% to 10%) of people suffering from intestinal inflammation, which is therefore “very important.” “Perhaps more striking, however, is the data on psoriatic arthritis, which should lead to continued research in this regard.

The study sheds light on the marked prevalence of bowel inflammation in this group of patients, which occurs more or less unnoticed and may have a major impact on their treatment. “We are trying to show the appropriate tools to identify these patients, as well as the clinical or laboratory indicators that can help identify them,” says Dr. Sanz at the 50th Congress of the Spanish Society of Rheumatology, which took place recently. in Maspalomas, Gran Canaria.

For her part, Dr. Ana Gutiérrez Casbas from the Gastroenterology Service of the General University Hospital of Alicante emphasizes that “it was observed that in some patients with spondyloarthritis, despite being monitored for rheumatological pathology, the diagnosis was not made” . . inflammatory bowel disease (IBD).

Of the total number of patients included in the study (559), 28 were diagnosed with IBD, the majority with Crohn’s disease. “All of this implies the importance of teamwork and establishing referral protocols for patients using fecal calprotectin. The study highlights the importance of considering digestive symptoms in patients with spondyloarthritis and supports the usefulness of a surrogate marker such as fecal calprotectin in screening patients who may have IBD to avoid delaying the diagnosis and selecting treatment that will benefit. patient, while simultaneously treating joint and digestive pathologies,” the specialist points out.

In this regard, the importance of a multidisciplinary approach was emphasized, and it was noted that many hospitals already have multidisciplinary units for the treatment of immune-mediated diseases, and others have joint consultations between the rheumatology and digestive committees for joint management of patients. which represents an achievement in the fight against both pathologies.

According to the main investigators, this was a very ambitious study that included a large number of patients, 559 of whom 272 had psoriatic arthritis and 287 had axial spondyloarthritis. The study provides real-world data in Spain, taking into account that it involved 13 centers located throughout the country. Thus, the sample size is representative, as is the geographic distribution of patients.

This EISER (Prevalence of Undiagnosed Inflammatory Bowel Disease in Patients with Spondyloarthritis) study, sponsored by Johnson & Johnson, “is a stimulus for continued work in this area because of the interest it generates and the amount of interesting data we have extracted.” must continue to cleanse,” they conclude.