Sanz-Sanz Jesús, Gutiérrez-Casbas Ana, Plaza Zulema, Gratacós Jordi, Rodríguez-Lago Iago, Marín-Jiménez Ignacio, Trujillo-Martín Elisa, Pérez-Pampín Eva, Barreiro-de Acosta Manuel, Hernández-Hernández María Vanesa, Carrillo-Palau Marta, García-Vivar María Luz, Muñoz-Villafranca María Carmen, Ladehesa-Pineda Maria Lourdes, Iglesias-Flores Eva, Merino-Argumánez Carolina, González-Lama Yago, Arévalo-Salaet Marta, Calvet Xavier, Díaz-Gonzalez Federico
Departamento de Reumatología, Hospital Universitario Puerta de Hierro, Majadahonda, 28222 Madrid, Spain.
Departamento de Gastroenterología, Hospital General Universitario de Dr. Balmis de Alicante Servicio Digestivo, ISABIAL y CIBERehd, 03010 Alicante, Spain.
J Clin Med. 2025 Jun 27;14(13):4569. doi: 10.3390/jcm14134569.
: The prevalence of inflammatory bowel disease (IBD) in spondyloarthritis (SpA) patients is unknown. Our objective was to assess the prevalence of undiagnosed IBD in SpA patients, including those with axial spondylarthritis (axSpA) or psoriatic arthritis (PsA). Additionally, we examined fecal calprotectin (FC) levels in relation to the accuracy of IBD diagnosis. : EISER was a cross-sectional, multicenter, observational, rheumatologist-gastroenterologist collaborative study. Patients with SpA naïve to biologics were recruited. Demographic and clinical characteristics, disease activity, and treatment information were collected. Patients with FC ≥ 80 µg/g or IBD-related symptoms underwent a colonoscopy or video capsule endoscopy. Receiver operating characteristic analysis assessed the predictive value of FC for IBD diagnosis. : Of the 570 patients recruited, 494 were evaluable for the main outcome, 248 (50.2%) had axSpA, and 246 (49.8%) had PsA. Overall, 28/494 patients were diagnosed with IBD (5.7%, 95%CI 3.6-7.7). Sorted by clinical entity, 22 (8.9%, 95%CI 5.3-12.4) axSpA and 6 (2.4%, 95%CI 0.5-4.4) PsA patients had a diagnosis of IBD: 24 (86%, 95%CI 79.4-92.6) had ileal/ileocolonic Crohn's disease (CD), 3 (11%, 95%CI 5.1-16.9) unclassified IBD, and 1 (3.5%, 95%CI 0.0-6.9) ulcerative colitis. The ROC curve for FC and IBD diagnosis (AUC: 0.870, < 0.001, 95%CI 83.7-89.8) showed that an FC ≥ 147 µg/g had a positive predictive value of 17.4% (95%CI 14.5-20.8) : In SpA, the prevalence of undiagnosed IBD was 5.7%, higher in axSpA (8.9%) than in PsA (2.4%) patients, with CD being the most common. SpA patients with FC levels < 147 µg/g had a very low probability of IBD.
脊柱关节炎（SpA）患者中炎症性肠病（IBD）的患病率尚不清楚。我们的目的是评估SpA患者中未确诊的IBD的患病率，包括那些患有轴向脊柱关节炎（axSpA）或银屑病关节炎（PsA）的患者。此外，我们还研究了粪便钙卫蛋白（FC）水平与IBD诊断准确性的关系。
EISER是一项横断面、多中心、观察性、风湿病学家-胃肠病学家合作研究。招募了未使用过生物制剂的SpA患者。收集了人口统计学和临床特征、疾病活动度及治疗信息。FC≥80μg/g或有IBD相关症状的患者接受了结肠镜检查或视频胶囊内镜检查。受试者工作特征分析评估了FC对IBD诊断的预测价值。
在招募的570例患者中，494例可用于主要结局评估，其中248例（50.2%）患有axSpA，246例（49.8%）患有PsA。总体而言，494例患者中有28例（5.7%，95%CI 3.6-7.7）被诊断为IBD。按临床类型分类，22例（8.9%，95%CI 5.3-12.4）axSpA和6例（2.4%，95%CI 0.5-4.4）PsA患者被诊断为IBD：24例（86%，95%CI 79.4-92.6）患有回肠/回结肠克罗恩病（CD），3例（11%，95%CI 5.1-16.9）为未分类IBD，1例（3.5%，95%CI 0.0-6.9）为溃疡性结肠炎。FC与IBD诊断的ROC曲线（AUC：0.870，<0.001，95%CI 83.7-89.8）显示，FC≥147μg/g的阳性预测值为17.4%（95%CI 14.5-20.8）。
在SpA中，未确诊IBD的患病率为5.7%，axSpA患者（8.9%）高于PsA患者（2.4%），其中CD最为常见。FC水平<147μg/g的SpA患者患IBD概率极低。
