Jan Reem, Hong Simon J, Ermann Joerg
University of Chicago Medicine, Chicago, IL, USA.
University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL, USA.
Curr Rheumatol Rep. 2025 Feb 1;27(1):17. doi: 10.1007/s11926-025-01181-0.
There is an unmet need to adequately identify, describe and treat the musculoskeletal manifestations of patients with inflammatory bowel disease (IBD). At the 2024 SPARTAN annual meeting, we reviewed the current literature on the prevalence and presentation of spondyloarthritis in patients with IBD and discussed screening strategies to select symptomatic patients for further study. The primary goal is to improve understanding and recognition of spondyloarthritis in this patient population.
In a unique collaboration between U.S. gastroenterologists and rheumatologists, the Gastroenterology and Rheumatology assessment of Spondyloarthritis in Inflammatory Bowel Disease (GRaSp-IBD) study group designed and executed a multi-center study across six institutions that applied a hybrid screening tool to identify patients with musculoskeletal symptoms suggestive of spondyloarthritis. The data was analyzed for confirmed rheumatic disease, treatment history, patient and IBD characteristics. Of the patients that screened positive, the majority (69%) had not seen a rheumatologist within the past year. IBD phenotype did not seem to increase the risk of a positive screen, but a higher number of biologic exposures proved significant. IBD patients report musculoskeletal pain at a high rate but a minority of these patients are seen by rheumatologists. Further study is needed to determine how to optimize screening for IBD arthritis, and to improve referral rates and clinical outcomes.
目前存在未满足的需求,即需要充分识别、描述和治疗炎症性肠病(IBD)患者的肌肉骨骼表现。在2024年斯巴达年度会议上,我们回顾了关于IBD患者脊柱关节炎患病率和表现的当前文献,并讨论了筛选策略,以挑选有症状的患者进行进一步研究。主要目标是增进对这一患者群体中脊柱关节炎的理解和认识。
在美国胃肠病学家和风湿病学家的一次独特合作中,炎症性肠病脊柱关节炎的胃肠病学和风湿病学评估(GRaSp-IBD)研究小组设计并在六个机构开展了一项多中心研究,该研究应用了一种混合筛查工具来识别有脊柱关节炎提示性肌肉骨骼症状的患者。对确诊的风湿性疾病、治疗史、患者和IBD特征的数据进行了分析。在筛查呈阳性的患者中,大多数(69%)在过去一年中未看过风湿病学家。IBD表型似乎并未增加筛查阳性的风险,但生物制剂暴露次数较多被证明具有显著性。IBD患者报告肌肉骨骼疼痛的比例很高,但这些患者中只有少数看过风湿病学家。需要进一步研究以确定如何优化IBD关节炎的筛查,并提高转诊率和临床结局。