SAT0266 Use of conventional synthetic dmards and biological dmards in patients with enteropathic spondyloarthritis: a combined gastro-rheumatological approach

Chimenti, Maria Sole; Conigliaro, Paola; Triggianese, Paola; Canofari, Claudia; Cedola, Francesca; Onali, S.; Calabrese, Emma; Petruzziello, Carmine; Ruffa, A.; Monteleone, Giovanni; Biancone, Livia; Perricone, Roberto

doi:10.1136/annrheumdis-2018-eular.3513

Cited by 5 publications

(9 citation statements)

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“…Although rates of peripheral and axial involvement in eSpA are different in the studies, peripheral involvement rate is higher than the rate of axial involvement. In the study by Chimenti et al (12), 65% of eSpA patients had peripheral involvement, while 35% of the patients had axial involvement. In another study, the rate of only peripheral involvement was 53% in eSpA patients, while the rate of only axial involvement was 26% (13).…”

Section: Discussionmentioning

confidence: 91%

Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry

Farisoğullari

Yardimci

Sarı

et al. 2022

Clinical and Experimental Rheumatology

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ObjectiveTo compare enteropathic spondylitis (ES) with psoriatic spondylitis (PS) and ankylosing spondylitis (AS), in patients on biological disease-modifying anti-rheumatic drug (bDMARD) treatment. MethodPatients who were enrolled in the HUR-BIO registry were included. ES patients were considered as the main study group; AS and PS patients were included as the control groups. ES was defined as patients with inflammatory bowel disease (IBD) having inflammatory back pain/spine symptoms plus radiological sacroiliitis. , 128 AS patients (39.1% female), and 92 PS patients (62% female) were analysed. Results SixtyBaseline erythrocyte sedimentation rate (ESR) was significantly higher in the ES group than in the AS group. Both the baseline ESR and C-reactive protein were also higher in the ES group compared with the PS group. Among the first bDMARD use, infliximab use was higher in the ES group than the other groups. There was a marginal significant difference between the SpA subgroups in the retention rates of the first bDMARDs (log-rank, p=0.059). Ulcerative colitis was a significant predictor for switching of bDMARDs in comparison to Crohn's disease. Regarding the treatment responses, no significant differences were relevant for the three groups in terms of 50% improvement of the initial Bath Ankylosing Spondylitis Disease Activity Index score, the Assessment of Spondyloarthritis International Society partial remission score, and 20% improvement of ASAS score. Conclusion A large majority of enteropathic spondyloarthritis patients on bDMARD treatment had radiographic sacroiliitis.ES patients had distinctive features that distinguish them from AS and PS patients.

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Section: Discussionmentioning

confidence: 91%

Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry

Farisoğullari

Yardimci

Sarı

et al. 2022

Clinical and Experimental Rheumatology

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“…In a small case series of 8 patients with refractory CD, authors retrospectively demonstrated a potential clinical effect in selected subgroup of difficult-to-treat CD patients. [2] In particular, 4 patients had a concomitant SpA and golimumab was effective in 2 of them while residual clinical symptoms and paradoxic psoriasis were observed in the other 2 patients. [2] …”

Section: Discussionmentioning

confidence: 95%

“… [2] In particular, 4 patients had a concomitant SpA and golimumab was effective in 2 of them while residual clinical symptoms and paradoxic psoriasis were observed in the other 2 patients. [2] …”

Section: Discussionmentioning

confidence: 95%

“…Although TNFi have the same target, switching from a different molecule may be effective. [2] However, this issue has been explored only in few cases of ESpA patients with CD and in none of them from both the gastroenterological and rheumatologic point of view (Table 2 ). Herein, in our case-series, ESpA patients were failure to 2 TNFi for both joint and intestinal manifestations.…”

Section: Discussionmentioning

confidence: 99%

“… [1] The association of IBD and Spondyloarthritis (SpA, enteropathic SpA—ESpA) has a prevalence up to 50% and requires an integrated approach for the management. [2] Treatment strategy may require a patient tailored-approach since primary non-response, secondary loss of response, or intolerance occur. Among the “big-five” family of tumor necrosis factor (TNF)-inhibitors (TNFi), adalimumab and infliximab are approved in Italy for CD.…”

Section: Introductionmentioning

confidence: 99%

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Two years follow-up of golimumab treatment in refractory enteropathic spondyloarthritis patients with Crohn disease

et al. 2021

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Golimumab is a fully human monoclonal antibody against tumor necrosis factor (TNF) approved for the treatment of ulcerative colitis and not for Crohn disease (CD). Many CD patients experience primary, secondary failure, or intolerance to other TNF inhibitors (TNFi) approved in Italy for CD (adalimumab and infliximab). Spondyloarthritis (SpA) may be associated with CD (enteropathic, ESpA) in up to 50% of patients requiring a multidisciplinary and tailored approach. However, only few data from literature and no formal trials determined the efficacy and safety of golimumab in ESpA patients. We performed a case series on 12 patients affected by active CD and active ESpA were failure or intolerant to previous TNFi approved in Italy for both SpA and CD, infliximab and adalimumab. Golimumab was administered following rheumatologic dosage (subcutaneous 50 mg monthly; 100 mg monthly for patients ≥100 kg). Gastrointestinal and rheumatologic disease activity was evaluated with a follow-up of 2 years. A total of 9 patients were followed for 2 years of golimumab treatment. CD clinical activity ameliorated as shown by the reduction of Harvey–Bradshaw index and Crohn disease activity index (CDAI) at 12 and 24 months of treatment ( P = .03 and P = .04, respectively) associated with reduction of C-reactive protein at 12 and 24 months ( P = .04 for both comparisons) of treatment. SpA assessment revealed a significant reduction in tender joint count at 6 ( P = .03), 12 ( P = .03), and 24 months ( P = .007) of treatment. Swollen joint count, pain, SpA disease activity, and disability reduced in several patients during the follow-up. No adverse events were registered in the follow-up. We demonstrate good clinical efficacy and safety profile of both gastrointestinal and rheumatologic involvement. This may indicate promising therapeutic option for ESpA patients affected by CD, and non-responsive to other TNFi.

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Impact of biological therapy in reducing the risk of arthritis development in inflammatory bowel diseases

Fatica,

Monosi,

Conigliaro

et al. 2024

RMD Open

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ObjectiveEvaluate spondyloarthritis (SpA) incidence in inflammatory bowel diseases (IBD) between patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) and conventional DMARDs (cDMARDs) and define risk factors associated with SpA development.MethodsRetrospective cohort study was conducted on patients with Crohn’s disease (CD) or ulcerative colitis (UC) and divided into two cohorts: cDMARDs or bDMARDs/targeted synthetic (ts) DMARDs treated patients. Rheumatological assessment was performed in patients presenting musculoskeletal symptoms. Multivariate analysis and Kaplan-Meier curves were used to evaluate the adjusted SpA risk development.Results507 patients were included in the study. 176 patients with CD received bDMARDs, 112 cDMARDs and 106 new SpA diagnosies were formulated. Females (OR 1.7 (95% CI 1.1 to 3), adjusted p=0.04), non-stricturing/non-penetrating phenotype (OR 2 (95% CI 1.1 to 3.4), adjusted p=0.01), psoriasis (OR 2.1 (95% CI 1 to 4.6), adjusted p=0.04) and non-infectious uveitis (OR 6.8 (95% CI 1.4 to 33.4), adjusted p=0.01) were associated with increased SpA risk development, while bDMARDs usage was protective (OR 0.4 (95% CI 0.2 to 0.8), adjusted p=0.01), statistically higher than cDMARDs throughout the entire follow-up (effect size 0.47). 98 patients with UC received b-tsDMARDs, 121 cDMARDs and 56 new SpA diagnoses were formulated. Females (OR 2.1 (95% CI 1 to 4.3), adjusted p=0.02) and psoriasis (OR 2.7 (95% CI 1 to 6.8), adjusted p=0.03) were associated with increased SpA risk development, while bDMARDs were protective for SpA development for up to 12 months of treatment compared with cDMARDs (p=0.03).ConclusionsbDMARDs treatment had an impact in reducing SpA development and clinical associated risk factors to transition from IBD to IBD-SpA emerged.

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SAT0266 Use of conventional synthetic dmards and biological dmards in patients with enteropathic spondyloarthritis: a combined gastro-rheumatological approach

Cited by 5 publications

References 0 publications

Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry

Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry

Two years follow-up of golimumab treatment in refractory enteropathic spondyloarthritis patients with Crohn disease

Impact of biological therapy in reducing the risk of arthritis development in inflammatory bowel diseases

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