Upadacitinib in a patient with concurrent refractory axial Spondyloarthritis and inflammatory bowel disease: A case report

Abstract

Axial spondyloarthritis (axSpA) is a chronic inflammatory arthritis that predominantly affects the spine, leading to stiffness, pain, and reduced mobility. 1 This condition is closely linked to another inflammatory disorder, namely inflammatory bowel disease (IBD). 2The incidence and prevalence of IBD are elevated in axSpA compared with the general population. The estimated overall incidence of IBD in patients with axSpA ranges from 5% to 10%. 3 IBD encompasses conditions such as Crohn's disease (CD) and ulcerative colitis (UC), both of which involve chronic inflammation of the gastrointestinal tract. The coexistence of axSpA and IBD in some individuals is known as spondyloarthritis with IBD, highlighting the intricate interplay between these inflammatory conditions. 4 Several diseasemodifying antirheumatic drugs (DMARDs), such as sulfasalazine, as well as biologic therapies, including TNF inhibitors (TNFi) and Janus kinase inhibitors (JAKi), have been utilized in the treatment of patients concurrently experiencing axSpA and IBD. 5 However, treating axSpA alongside IBD can be challenging. Here, we report a case in which Upadacitinib successfully treated a patient with concurrent refractory axSpA and IBD.