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比较脊柱关节炎与克罗恩病或溃疡性结肠炎的临床特征:来自ASAS-PerSpA研究的见解。

Comparing clinical profiles in spondyloarthritis with Crohn's disease or ulcerative colitis: insights from the ASAS-PerSpA study.

作者信息

Rios Rodriguez Valeria, Duran Tugba Izci, Torgutalp Murat, López-Medina Clementina, Dougados Maxime, Kishimoto Mitsumasa, Ono Keisuke, Protopopov Mikhail, Haibel Hildrun, Rademacher Judith, Poddubnyy Denis, Proft Fabian

机构信息

Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Clinic of Rheumatology, Denizli State Hospital, Denizli, Turkey.

出版信息

Rheumatol Adv Pract. 2024 May 22;8(2):rkae064. doi: 10.1093/rap/rkae064. eCollection 2024.

Abstract

OBJECTIVES

Assuming SpA manifestations may vary among patients with different inflammatory bowel disease (IBD) subtypes, we explored the clinical characteristics associated with the presence of Crohn's disease (CD) or ulcerative colitis (UC) in patients with spondyloarthritis (SpA).

METHODS

We included 3152 patients of ASAS-PerSpA study diagnosed with either axial SpA or peripheral SpA, according to their treating rheumatologist. Of these, 146 (4.6%) had confirmed IBD by endoscopy and were categorized into CD or UC groups. Demographics, clinical characteristics, treatments and patient-reported outcomes were compared between the two subgroups.

RESULTS

From 146 patients included in the current analysis, 87 (59.6%) had CD [75 (86.2%) axial SpA and 12 (13.8%) peripheral SpA], and 39 (26.7%) had UC [34 (87.2%) axial SpA and 5 (12.8%) peripheral SpA]. CD and UC groups had similar age with average of 44.9 (13.5) 44.0 (13.0) years, respectively, and a slight male predominance in CD (63.2%) compared with UC (51.3%). Diagnostic delay for SpA was 7.0 (6.9) years for CD and 8.8 (8.1) years for UC. Chronic back pain was the most reported symptom present in 95.4% of CD patients and 89.7% of UC patients. Both groups had similar musculoskeletal phenotyping, with higher frequency of psoriasis (15.4%) and uveitis 28.2% in UC; and higher tendency to be HLA-B27 positive in CD (51.9% in CD .s 39.4% in UC).

CONCLUSION

In our analysis patients with SpA and concurrent CD or UC had mainly similar musculoskeletal phenotypes. However, they differ slightly in extra-musculoskeletal manifestations and HLA-B27 prevalence.

摘要

目的

鉴于脊柱关节炎(SpA)的表现可能在不同炎症性肠病(IBD)亚型的患者中有所不同,我们探讨了脊柱关节炎(SpA)患者中与克罗恩病(CD)或溃疡性结肠炎(UC)存在相关的临床特征。

方法

我们纳入了ASAS-PerSpA研究中的3152例患者,根据其主治风湿病医生的诊断,这些患者被诊断为轴向SpA或外周SpA。其中,146例(4.6%)经内镜检查确诊为IBD,并被分为CD组或UC组。比较了两个亚组之间的人口统计学、临床特征、治疗方法和患者报告的结局。

结果

在本次分析纳入的146例患者中,87例(59.6%)患有CD[75例(86.2%)为轴向SpA,12例(13.8%)为外周SpA],39例(26.7%)患有UC[34例(87.2%)为轴向SpA,5例(12.8%)为外周SpA]。CD组和UC组年龄相似,平均分别为44.9(13.5)岁和44.0(13.0)岁,CD组男性略占优势(63.2%),而UC组为(51.3%)。SpA的诊断延迟在CD组为7.0(6.9)年,在UC组为8.8(8.1)年。慢性背痛是最常报告的症状,在95.4%的CD患者和89.7%的UC患者中存在。两组的肌肉骨骼表型相似,UC组中银屑病(15.4%)和葡萄膜炎(28.2%)的发生率较高;CD组中HLA-B27阳性的倾向更高(CD组为51.9%,UC组为39.4%)。

结论

在我们的分析中,患有SpA并发CD或UC的患者主要具有相似的肌肉骨骼表型。然而,它们在肌肉骨骼外表现和HLA-B27患病率方面略有不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0c1/11132819/8259c383f82a/rkae064f1.jpg

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