Falloon Katherine, Forney Michael, Husni M Elaine, Feagan Brian, Rieder Florian
Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Musculoskeletal Radiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Am J Gastroenterol. 2025 Jan 1;120(1):106-114. doi: 10.14309/ajg.0000000000003092. Epub 2024 Sep 23.
Inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA) is common but remains poorly understood. In this review article, we aimed to provide guidance regarding the diagnosis and management of this condition. For diagnosis of IBD-associated peripheral SpA (IBD-pSpA), we recommend collaboration with rheumatology for incorporation of clinical symptoms, physical examination findings, joint imaging if applicable, and available diagnostic criteria. For the management of IBD-pSpA, we first recommend assessment and treatment of underlying luminal IBD disease activity. We provide guidance regarding positioning of advanced therapies for IBD in patients with IBD-pSpA based on the limited available literature. For diagnosis of IBD-associated axial SpA, we recommend rheumatology referral to make the diagnosis based on incorporation of symptoms, laboratory data, imaging findings (sacroiliitis), and available diagnostic criteria. For the management of axial SpA, we recommend comanagement with rheumatology and use of either antitumor necrosis factor agents or Janus kinase inhibitors, when applicable.
炎症性肠病（IBD）相关的脊柱关节炎（SpA）很常见，但仍了解不足。在这篇综述文章中，我们旨在为该疾病的诊断和管理提供指导。对于IBD相关的外周性SpA（IBD-pSpA）的诊断，我们建议与风湿病学专家合作，综合考虑临床症状、体格检查结果、必要时的关节影像学检查以及可用的诊断标准。对于IBD-pSpA的管理，我们首先建议评估和治疗潜在的肠道IBD疾病活动。基于有限的现有文献，我们为IBD-pSpA患者中IBD的高级治疗定位提供指导。对于IBD相关的中轴性SpA的诊断，我们建议转诊至风湿病学专家，根据症状、实验室数据、影像学表现（骶髂关节炎）和可用的诊断标准进行诊断。对于中轴性SpA的管理，我们建议与风湿病学专家共同管理，并在适用时使用抗肿瘤坏死因子药物或 Janus 激酶抑制剂。
