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Abstract Number: 1308

The Presence of Spondyloarthritis Is Associated with Higher Clinical Disease Activity in Patients with Early Crohn’s Disease: Results of a Prospective Cohort Study

Valeria Rios Rodriguez1, Mikhail Protopopov1, Fabian Proft1, Susanne Lüders1, Judith Rademacher1, Hildrun Haibel1, Maryna Verba1, Joachim Sieper1, Elena Sonnenberg1, Lea Isabell Kredel1, Michael Schumann1, Britta Siegmund1 and Denis Poddubnyy2, 1Charité Universitätsmedizin Berlin, Berlin, Germany, 2Charité – Universitätsmedizin Berlin, Berlin, Germany

Meeting: ACR Convergence 2020

Keywords: Disease Activity, Spondylarthropathies

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Session Information

Date: Sunday, November 8, 2020

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster II: Extra-MSK & Comorbidities

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Inflammatory bowel disease (IBD) and specifically Crohn’s disease (CD) is known to be associated with spondyloarthritis (SpA) (1). However, only little is known about factors associated with the development of spondyloarthritis in CD. The purpose of this study is to identify factors associated with the presence of SpA in a cohort of patients with CD.

Methods: Patients with a definite diagnosis of CD naïve to or not being treated with biological agents for at least 3 months were included in a CD-arm of the German Spondyloarthritis Inception Cohort (GESPIC-Crohn). Gastroenterologists were encouraged to include consecutively recently diagnosed CD patients. Patients were classified according to the Montreal classification including location and behavior of CD. Patients received a structured assessment of SpA manifestations (including magnetic resonance imaging of sacroiliac joints and spine) by a rheumatologist who was responsible for the final diagnosis of SpA / no SpA. Clinical activity of CD was assessed by the Harvey-Bradshaw Index (HBI). In addition, colonoscopy was performed, Simple endoscopic Score for Crohn’s Disease (SES-CD) was determined and fecal calprotectin was measured.

Results: A total of 108 patients with CD were enrolled. The mean (mean ± SD) age was 36.6 ± 12.7 years, and CD symptom duration was 5.3 ± 7.4 years. At baseline, 44 (40.7%) patients were treated with non-biologic immunomodulating drugs: 16 (14.8%) patients received mesalazine, 27 (25.0%) azathioprine, and 1 (0.9%) methotrexate. Oral steroids were given to 38 (35.2%) patients. A total of 103 (96.3%) patients were biologics naïve. SpA was diagnosed in 23 (21.3%) patients: 12 had axial SpA and 11 peripheral SpA. Patients with SpA had higher prevalence of HLA-B27, of clinical SpA features (back pain, inflammatory back pain, peripheral arthritis, enthesitis), higher level of CRP and higher activity of CD as measured by the HBI. There were not substantial differences between SpA vs. non-SpA patients in terms of CD duration, endoscopic activity, disease location or behavior, or treatment, except for mesalazine, which was more frequently administered in patients with SpA than non-SpA (39.1% vs. 8.2%, p=0.001, respectively).

Conclusion: SpA was present in 21% of patients with CD in this early cohort with almost equal proportions of axial and peripheral forms. Presence of HLA-B27 and higher clinical activity of CD were associated with the presence of SpA.

TABLE. Baseline demographic and clinical characteristics of the included patients with Crohn’s disease with or without spondyloarthritis.

Figure. Spondyloarthritis manifestations in patients with Crohn’s disease.


Disclosure: V. Rios Rodriguez, None; M. Protopopov, None; F. Proft, Novartis, 2, 8, AbbVie, 8, AMGEN, 8, BMS, 8, Hexal, 8, Celgene, 8, Lilly, 8, MSD, 8, Pfizer, 8, Roche, 8, UCB, 8; S. Lüders, None; J. Rademacher, None; H. Haibel, None; M. Verba, None; J. Sieper, AbbVie, 5, Novartis, 5, 8, Lilly, 8, Janssen, 5, Merck, 5, 8; E. Sonnenberg, None; L. Kredel, None; M. Schumann, None; B. Siegmund, AbbVie, 8, Boehringer, 8, Celgene, 8, Falk, 8, Janssen, 8, Lilly, 8, Pfizer, 8, Prometheus, 8, Takeda, 8, CED Service GmbH, 8, Ferring, 8; D. Poddubnyy, Eli Lilly and Company, 2, 5, 8, MSD, 2, 5, 8, Novartis, 2, 5, 8, Pfizer, 2, 5, 8, BioCad, 5, Gilead, 5, GSK, 5, UCB, 5, 8, BMS, 8.

To cite this abstract in AMA style:

Rios Rodriguez V, Protopopov M, Proft F, Lüders S, Rademacher J, Haibel H, Verba M, Sieper J, Sonnenberg E, Kredel L, Schumann M, Siegmund B, Poddubnyy D. The Presence of Spondyloarthritis Is Associated with Higher Clinical Disease Activity in Patients with Early Crohn’s Disease: Results of a Prospective Cohort Study [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/the-presence-of-spondyloarthritis-is-associated-with-higher-clinical-disease-activity-in-patients-with-early-crohns-disease-results-of-a-prospective-cohort-study/. Accessed February 24, 2021.
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