Ali Aaisham, Schmidt Melanie, Piskin David, Crowley Eileen, Berard Roberta
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Lawson Health Research Institute, London, Ontario, Canada.
ACR Open Rheumatol. 2022 Jun;4(6):547-554. doi: 10.1002/acr2.11431. Epub 2022 Mar 29.
Pediatric inflammatory bowel disease (p-IBD) is a chronic relapsing gastrointestinal disorder of childhood with long-term morbidity. Several extraintestinal manifestations are described, the most common being joint pain and/or inflammation. However, patient and disease characteristics, treatments, and outcomes of p-IBD-associated musculoskeletal disease are not well established. Our study aims to summarize the recent literature on the epidemiology of musculoskeletal manifestations in p-IBD in the era of biologics.
A systematic search of PubMed, Embase, Cochrane Library, Web of Science Core Collection, and Cumulative Index to Nursing and Allied Health Literature databases was performed with relevant keywords. Studies in English published from January 1, 2000, to December 21, 2020, were included. In total, 3893 articles were identified and screened. Study and population characteristics and outcomes of interest were recorded. Risk of bias assessment was performed using the Joanna Briggs Institute Critical Appraisal Tools.
Thirteen studies were included for full review, which were primarily single-center observational studies with retrospective or cross-sectional designs. The diagnostic criteria and definitions used for musculoskeletal manifestations varied. Musculoskeletal manifestation prevalence ranged from 2% to 35%. Only one study assessed the response of musculoskeletal manifestations to biologics. Risk of bias demonstrated heterogeneity in study quality.
This is the first systematic review of musculoskeletal manifestations in p-IBD. Analysis was limited because of variability in study design and data-reporting methods. Definitions varied among included studies, with a clear lack in standardization. Our study demonstrates the need for standardized assessment of musculoskeletal manifestations of p-IBD and further research to explore optimal management to advance care for this group of children.
儿童炎症性肠病（p-IBD）是一种慢性复发性儿童胃肠道疾病，具有长期发病率。有几种肠外表现被描述，最常见的是关节疼痛和/或炎症。然而，p-IBD相关肌肉骨骼疾病的患者和疾病特征、治疗方法及结果尚未完全明确。我们的研究旨在总结生物制剂时代p-IBD肌肉骨骼表现流行病学的最新文献。
使用相关关键词对PubMed、Embase、Cochrane图书馆、科学网核心合集以及护理及相关健康文献累积索引数据库进行系统检索。纳入2000年1月1日至2020年12月21日发表的英文研究。共识别并筛选出3893篇文章。记录研究和人群特征以及感兴趣的结果。使用乔安娜·布里格斯研究所的批判性评价工具进行偏倚风险评估。
纳入13项研究进行全面综述，这些研究主要是具有回顾性或横断面设计的单中心观察性研究。用于肌肉骨骼表现的诊断标准和定义各不相同。肌肉骨骼表现的患病率在2%至35%之间。只有一项研究评估了肌肉骨骼表现在生物制剂治疗下的反应。偏倚风险显示研究质量存在异质性。
这是对p-IBD肌肉骨骼表现的首次系统综述。由于研究设计和数据报告方法的变异性，分析受到限制。纳入研究中的定义各不相同，明显缺乏标准化。我们的研究表明需要对p-IBD的肌肉骨骼表现进行标准化评估，并进一步开展研究以探索最佳管理方法，从而改善对这组儿童的护理。
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