Small Intestine Enteropathy In Patients With Rheumatoid Arthritis and Osteoarthritis, Taking Regularly Non-Steroidal Antirheumatic Drugs . Has The Basic Disease Effect On Incidence and Degree Of Damage?

Petr Bradna¹, Ilja Tachecí², Drahomira Bastecka³, Stanislav Rejchrt³, Jan Bures⁴ and Marcela Kopacova⁵, ¹2nd Gastroenterological Department of Internal Medicine, Charles University Prague Faculty of Medicine Hradec Kralove and University Hospital, Hradec Králové, Czech Republic, ²Charles University Prague Faculty of Medicine Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic, ³2nd Gastroenterological Department of Internal Medicine, Charles University Prague Faculty of Medicine Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic, ⁴Charles University Prague,Medical Faculty Hradec Kralove and University Hospital, Hradec Kralove, Hradec Kralove, Czech Republic, ⁵2nd Gastroenterological Department of Internal Medicine, Charles University Prague, Medical Faculty Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: gastrointestinal complications

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects I: Comorbidities in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The involvement of small intestine is demonstrable up to 72% of patients, using non-steroidal antirheumatic drugs (NSAIDs). Quite a few is known about the influence of the principal diagnosis on incidence and severity of enteropathy. The aim of our study was to compare small bowel enteropathy in rheumatoid arthritis and osteoarthritis patients, which are regularly use NSAIDs .

Methods:

Capsule endoscopy is currently the leading method for non-invasive diagnostics of small bowel lesions. This method is safe, reproducible, with high diagnostic yield, discriminating extend localization, severity and character of lesions. .

We examined 37 rheumatoid arthritis (RA) patients and 14 patients, using NSAIDs on a regular basis for osteoarthritis (OA). Group of 13 healthy persons, who are not using NSAIDs served as a control group. We excluded people with comorbidities potentially involving the bowel or leading to a blood loss.

We evaluated extend, severity and localizations of lesions. Qualitative data were evaluated by Fisher´s exact test, Armitage test or chi2 test , quantitative data were evaluated by Student´s T-test or Mann Whitney test in case of nonparametric distribution.

Results:

We demonstrated enteropathy in 67.5% of rheumatoid arthritis patients, moderate or severe lesions in 20% of RA patients. In osteoarthritis group there were 42.9% patients with enteropathy, severe in 7% of them. In control group there were demonstrated only mild changes in 15% people. Moderate or severe lesions were not demonstrated in NSAIDs non-users. Lesions were equally frequent in ileum and jejunum, duodenum was involved rarely. The same distribution was demonstrated also in moderate and severe lesions.

Conclusion:

Rheumatoid arthritis patients, using non-steroidal antirheumatic drugs, have significantly more frequent and more severe lesions of small bowel, then osteoarthritis NSAIDs users.

Jejunum and ileum were involved with equal frequency and severity, duodenal involvement was rare. Next studies should reply, if differences are caused by genetic predisposition,

co-medication, or they are caused by direct impact of rheumatoid arthritis.

Disclosure:

P. Bradna,
None;

I. Tachecí,
None;

D. Bastecka,
None;

S. Rejchrt,
None;

J. Bures,
None;

M. Kopacova,
None.

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