Ben Nessib Dorra, Ferjani Hanene, Maatallah Kaouther, Rahmouni Safa, Kaffel Dhia, Hamdi Wafa
Rheumatology Department, Kassab Orthopedics Institute, Mannouba, Tunisia.
Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia.
Clin Rheumatol. 2020 Dec;39(12):3543-3553. doi: 10.1007/s10067-020-05136-x. Epub 2020 May 18.
Management of spondyloarthritis (SpA) in patients with inflammatory bowel disease (IBD) remains a challenging task that requires multidisciplinary collaboration. Separate guidelines for each disease are well-established. However, the management of SpA co-occurring with Crohn's disease (CD) or ulcerative colitis (UC) has hardly been studied. There are few specific reports that focus on this therapeutic area. The main issue is that some therapeutic options used to treat one disease can negatively influence the other disease course. This study aims to evaluate the therapeutic alternatives that would allow for the appropriate management of patients with both SpA and IBD. Key Points • Collaboration between gastroenterologists and rheumatologists is recommended to improve the management of patients with spondyloarthritis (SpA) and inflammatory bowel disease (IBD). • When treating SpA occurring simultaneously with IBD, it would be appropriate to give priority to the active disease. • Considering its well-proven efficacy in both conditions, anti-tumor necrosis factor (TNF) therapy remains the corner stone in the treatment of these patients. • Other therapeutic options such as Janus kinases (JAK) inhibitors, interleukin (IL)-23 and IL-12 inhibitors, and vedolizumab are still under investigation.
炎症性肠病（IBD）患者的脊柱关节炎（SpA）管理仍然是一项具有挑战性的任务，需要多学科协作。每种疾病都有完善的单独指南。然而，与克罗恩病（CD）或溃疡性结肠炎（UC）同时发生的SpA管理几乎没有得到研究。很少有专注于这一治疗领域的具体报告。主要问题是，用于治疗一种疾病的一些治疗选择可能会对另一种疾病的病程产生负面影响。本研究旨在评估能够对同时患有SpA和IBD的患者进行适当管理的治疗替代方案。要点•建议胃肠病学家和风湿病学家合作，以改善脊柱关节炎（SpA）和炎症性肠病（IBD）患者的管理。•当治疗与IBD同时发生的SpA时，优先治疗活动性疾病是合适的。•考虑到其在两种情况下都已得到充分证实的疗效，抗肿瘤坏死因子（TNF）治疗仍然是这些患者治疗的基石。•其他治疗选择，如Janus激酶（JAK）抑制剂、白细胞介素（IL）-23和IL-12抑制剂以及维多珠单抗仍在研究中。
