ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1310

Clinical Characteristics of Patients with SpA and Concomitant IBD: Results from the ASAS PerSpA Study

Keisuke Ono1, Mitsumasa Kishimoto2, Gautam Deshpande3, Sho Fukui4, Satoshi Kawaai5, Haruki Sawada6, Minoru Matsuura7, Valeria Rios Rodriguez8, Fabian Proft8, Kurisu Tada6, Naoto Tamura6, Yoshinori Taniguchi9, Ayako Hirata10, Hideto Kameda10, Shigeyoshi Tsuji11, Yuko Kaneko12, Hiroaki Dobashi13, Tadashi Okano14, Yoichiro Haji15, Akimichi Morita16, Akihiko Asahina17, Masato Okada18, Yoshinori Komagata1, Clementina López Medina19, Anna Molto20, Désirée van der Heijde21, Maxime Dougados22, Tadakazu Hisamatsu7, Tetsuya Tomita23 and Shinya Kaname1, 1Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan, 2Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Yokohama, Japan, 3Department of General Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, 4Immuno-Rheumatology Center, St. Luke’s International Hospital, and Center for clinical epidemiology, St. Luke’s International University, Tokyo, Japan, 5Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan, Chuo-ku, Tokyo, Japan, 6Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo, Japan, 7Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan, 8Charité University Medicine Berlin, Berlin, Germany, 9Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi, Japan, 10Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan, 11Department of Orthopedics and Rheumatology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan, 12Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan, 13Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kita-gun, Japan, 14Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan, 15Department of Rheumatology, Daido Hospital, Nagoya, Japan, 16Department of Geriatric and Environmental Dermatology, Nagoya City University, Nagoya, Japan, 17Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan, 18Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan, 19Department of Rheumatology, Reina Sofia Hospital, IMIBIC, University of Cordoba, Cordoba, Spain/ Department of Rheumatology, University of Paris, Cochin Hospital, Paris, France, 20Rheumatology department, Cochin hospital, APHP, Paris, France, 21Department of Rheumatology, Leiden University Medical Center, Meerssen, Netherlands, 22Université de Paris . Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris . INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France., Paris, France, 23Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita Osaka, Japan

Meeting: ACR Convergence 2021

Keywords:

Session Information

Date: Monday, November 8, 2021

Session Title: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes III: Comorbidities, Extra-muskuloskeletal Manifestations, & Related Conditions (1304–1328)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: A recent study reports that gut inflammation is linked to degree of bone marrow edema in sacroiliac joints in patients with axial spondyloarthritis (SpA). SpA patients with concomitant inflammatory bowel disease (IBD) typically have more severe disease requiring aggressive treatment. However, the clinical characteristics of SpA patients with IBD has not been shown in a large cohort and there are few descriptions of regional differences.

The purpose of this study is to clarify the clinical characteristics of SpA patients with IBD compared to those SpA patients without IBD. In addition, we aim to determine the phenotype of patients given a definitive diagnosis of IBD-associated SpA by their treating rheumatologist.

Methods: Using ASAS-PerSpA data, an observational study, we analyzed information on demographics and disease characteristics, dichotomizing patients by IBD status. SpA patients with IBD were further categorized by region; Japan, non-Japan Asia, and non-Asian countries. SpA patients with IBD were also categorized as IBD-associated SpA or other SpA with IBD by their rheumatologists.

Results: Among 4465 SpA patients included in the study, 287 were identified with IBD. Compared to those without IBD, SpA patients with IBD were less likely male (54.0 vs 61.5%) and more likely to have experienced diagnostic delay (5.1 vs 2.9 years) (Table 1). SpA patients with IBD had lower prevalence of positive HLA-B27 (37.2% vs 68.0%) and less dactylitis (9.1% vs 15.8%) despite similar rates of other peripheral signs. Disease activity, radiographic sacroiliitis and inflammation on MRI were similar in the two groups. csDMARDs and bDMARDs use was higher in SpA patients with IBD.

With respect to regional differences, SpA patients with IBD was more common in Japan than in both non-Japan Asia and non-Asian countries (13.2, 1.7 and 7.1%, respectively). SpA patients with IBD in Japan experienced more diagnostic delay (12.8, 0.3 and 5.0 years, respectively), had lower prevalence of positive HLA-B27 (0, 81.8 and 36.2%, respectively) and less axial symptom (inflammatory back pain: 57.7, 84.6 and 81.9%, radiographic sacroiliitis: 23.1,46.2 and 60.9%, sacroiliitis on MRI: 33.3, 83.3 and 71.3%, respectively).

SpA patients with IBD were categorized by rheumatologists into their respective clinical diagnoses, of which 111 were diagnosed with IBD-associated SpA (Figure 1). IBD-associated SpA patients, compared to those diagnosed as primarily SpA patients with IBD but not IBD-associated SpA, had lower prevalence of both HLA-B27 (19.3 vs 45.2%) and family history of SpA (24.3 vs 39.8%) (Table 2). IBD-associated SpA patients had fewer axial symptom and signs, and were more likely to have peripheral arthritis – especially oligoarthritis. In IBD-associated SpA patients, IBD appears more often as the first symptom of SpA, and IBD-specific treatment was needed more frequently. csDMARDs use was higher in IBD-associated SpA.

Conclusion: SpA patients with IBD required more specific treatments than those without IBD. In SpA patients with IBD, rheumatologists tended to diagnose IBD-associated SpA in those without axial signs but with peripheral signs, and those with IBD as the initial symptom and requiring IBD-specific treatment.

Table 1. Clinical Characteristics of SpA patients with IBD.

Figure 1. Final clinical diagnosis of SpA patients with IBD patients by rheumatologists. (N&#3f287)

Table 2. Clinical Characteristics of IBD-associated SpA compared to other SpA patients with IBD.

Disclosures: K. Ono, a, 1; M. Kishimoto, AbbVie, 2, 6, Amgen-Astellas BioPharma, 2, 6, Asahi-Kasei Pharma, 2, 6, Astellas, 2, 6, Ayumi Pharma, 2, 6, BMS, 2, 6, Chugai, 2, 6, Daiichi-Sankyo, 2, 6, Eisai, 2, 6, Eli Lilly, 2, 6, Gilead, 2, 6, Janssen, 2, 6, Kyowa Kirin, 2, 6, Novartis, 2, 6, Ono Pharma, 2, 6, Pfizer, 2, 6, Tanabe-Mitsubishi, 2, 6, Teijin Pharma, 2, 6, UCB Pharma, 2, 6; G. Deshpande, None; S. Fukui, None; S. Kawaai, None; H. Sawada, None; M. Matsuura, Janssen Pharmaceutical K.K., 2, 6, Takeda Pharmaceutical Co. Ltd., 2, 6, AbbVie GK, 2, 6, Mitsubishi Tanabe Pharma Corporation, 2, 6, Kyorin Pharmaceutical Co. Ltd., 2, 6, Mochida Pharmaceutical Co., Ltd., 2, 6, JIMRO Co., 2, 6, Nippon Kayaku Co. Ltd., 2, 6, Mylan EPD G.K., 2, 6, Aspen Japan Co. Ltd., 2, 6; V. Rios Rodriguez, None; F. Proft, Novartis, 6; K. Tada, None; N. Tamura, AbbVie Japan GK, 6, Bristol-Myers Squibb Co. Ltd, 6, Chugai Pharmaceutical Co. Ltd, 6, Eisai Co. Ltd, 6, Eli Lilly Japan K.K, 6, Glaxo Smith Kline K.K., 6, Janssen Pharmaceutical K.K., 6, Mitsubishi-Tanabe Pharma Co., 6, Novartis Pharma K.K, 6; Y. Taniguchi, None; A. Hirata, None; H. Kameda, Asahi-Kasei, 2, 5, 6, Novartis, 2, 5, 6, AbbVie, 2, 5, 6, Chugai, 5, 6, Mitsubishi-Tanabe, 5, 6, Astellas, 2, Eli Lilly, 2, 6, Pfizer, 6, Eisai, 5, 6, Gilead Sciences, 2, Janssen, 2, 6, Sanofi, 2, UCB, 2; S. Tsuji, None; Y. Kaneko, None; H. Dobashi, None; T. Okano, None; Y. Haji, None; A. Morita, None; A. Asahina, Sun Pharmaceutical Industries, Inc., 5, 6, AbbVie, 5, 6, Janssen, 5, 6, Celgene, 5, 6, Eisai, 5, 6, Kyowa Kirin, 5, 6, LEO Pharma, 5, 6, Maruho, 5, 6, Mitsubishi Tanabe Pharma, 5, 6, Taiho Pharma, 5, 6, Torii Pharmaceutical, 5, 6, UCB, 5, 6, Eli Lilly Japan, 5, 6; M. Okada, AbbVie, 2, Eli Lilly, 2, AbbVie Japan, 6, Eli Lilly and Company, 6, Ono Pharmaceutical, 6; Y. Komagata, None; C. López Medina, None; A. Molto, None; D. van der Heijde, AbbVie, 2, Amgen, 2, Astellas, 2, AstraZeneca, 2, Bayer, 2, BMS, 2, Boehringer Ingelheim, 2, Celgene, 2, Cyxone, 2, Daiichi, 2, Eisai, 2, Eli Lilly, 2, Galapagos, 2, Gilead, 2, GlaxoSmithKline, 2, Janssen, 2, Merck, 2, Novartis, 2, Pfizer, 2, Regeneron, 2, Roche, 2, Sanofi, 2, Takeda, 2, UCB Pharma, 2, Imaging and Rheumatology BV, 4; M. Dougados, AbbVie, 2, 5, Bristol-Myers Squibb, 2, 5, Eli Lilly, 2, 5, Merck, 2, 5, Novartis, 2, 5, Pfizer Inc, 2, 5, Roche, 2, 5, UCB, 2, 5; T. Hisamatsu, Alfresa Pharma Co., Ltd., 5, Mitsubishi Tanabe Pharma Corporation, 2, 5, 6, EA Pharma Co., Ltd., 2, 5, 6, AbbVie GK, 2, 5, 6, JIMRO Co., Ltd., 2, 5, 6, Zeria Pharmaceutical Co., Ltd., 5, Daiichi-Sankyo, 5, Nippon Kayaku Co., Ltd., 5, Pfizer Inc., 2, 5, 6, Mochida Pharmaceutical Co., Ltd., 2, 5, 6, Celgene K.K., 2, 6, Kyorin Pharmaceutical Co. Ltd., 2, 5, 6, Janssen Pharmaceutical K.K., 2, 6, Takeda Pharmaceutical Co., Ltd., 2, 5, 6; T. Tomita, None; S. Kaname, None.

To cite this abstract in AMA style:

Ono K, Kishimoto M, Deshpande G, Fukui S, Kawaai S, Sawada H, Matsuura M, Rios Rodriguez V, Proft F, Tada K, Tamura N, Taniguchi Y, Hirata A, Kameda H, Tsuji S, Kaneko Y, Dobashi H, Okano T, Haji Y, Morita A, Asahina A, Okada M, Komagata Y, López Medina C, Molto A, van der Heijde D, Dougados M, Hisamatsu T, Tomita T, Kaname S. Clinical Characteristics of Patients with SpA and Concomitant IBD: Results from the ASAS PerSpA Study [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/clinical-characteristics-of-patients-with-spa-and-concomitant-ibd-results-from-the-asas-perspa-study/. Accessed December 7, 2021.

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