Editorial: shedding new light on extraintestinal manifestations in inflammatory bowel disease

Abstract

Extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD) were first described in 1976. 1 The anti-tumour necrosis factors agents signed the emergence of potent systemic treatment in IBD, allowing us to look beyond the gut and effectively treat these manifestations along with the luminal disease. 2 In the early 2000s, a landmark positive randomised controlled trial was conducted with infliximab for pyoderma gangrenosum. 3 A few years later, with the vedolizumab approval, the concept of gut-selectivity raised some concerns about the efficacy of new biologics for EIMs. 4 After a three-step meeting, Falloon et al. 5 proposed some guidance for diagnosis, management and follow-up on five major EIMs: erythema nodosum, pyoderma gangrenosum, uveitis, peripheral arthritis and axial arthritis. 5 This US (United States) consensus involved 12 IBD specialists, four rheumatologists, three ophthalmologists, six dermatologists and four patient representatives. The main strength of

Editorial: shedding new light on extraintestinal manifestations in inflammatory bowel disease—authors’ reply

“…We agree with the EXTRA authors regarding the complimentary but distinct goals of our two initiatives 2,3 . The EXTRA consensus was designed specifically to identify EIM endpoints for use in clinical trials 1 . The findings of their panel, including the need for subspecialty involvement and dedicated follow‐up every 4–12 weeks depending on the EIM in question, is consistent with this objective 2 .…”

“…We would like to thank Dr. Guillo and colleagues for their thoughtful editorial, 1 for highlighting our manuscript and for their contributions to the literature surrounding extra‐intestinal manifestations (EIMs) in inflammatory bowel disease (IBD). EIMs represent a critically unmet need, with limited data to guide management.…”