A recent study presented at the Spondyloarthritis Research and Treatment Network (SPARTAN) 2024 Annual Meeting in Cleveland has revealed that over 40% of patients with inflammatory bowel disease (IBD) screened positive for joint pain symptomatic of spondyloarthritis (SpA). Surprisingly, 75% of these patients did not have any prior history of arthritis, indicating a significant unmet need for rheumatological evaluation among this population.
Study Insights
Dr. Reem Jan, a rheumatologist from the University of Chicago Medicine, highlighted that musculoskeletal symptoms, particularly inflammatory back pain, are common in IBD patients. Despite this, only a minority of these patients are evaluated by rheumatologists. The study’s findings underscore the importance of addressing this gap in care.
Key Findings:
Sample and Screening: The study included 669 patients from multiple medical centers, including NYU Langone Health, Brigham and Women’s Hospital, and the Mayo Clinic, among others.
Positive Screens: 41% (275) of the participants screened positive for joint pain indicative of SpA.
Previous Diagnosis: Only 25% of the patients who screened positive were previously known to have SpA.
Rheumatology Consultation: Just 24% of the positive-screen patients had seen a rheumatologist in the previous year.
Common Symptoms: The most frequently reported symptoms included inflammatory back pain, peripheral joint pain, and heel pain.
Risk Factors for Positive Screening:
The study also identified several risk factors associated with a higher likelihood of screening positive for SpA among IBD patients:
Female Sex: Odds ratio (OR) of 2.0
Older Age: OR of 1.02 per year
History of Smoking: OR of 1.7
Prior IBD-related Surgery: OR of 1.60
History of Biologic or Small Molecule Therapy: OR of 2.3
Future Directions
Dr. Mark Hwang from UTHealth Houston commented on the clinical implications of these findings, noting the high rates of joint pain in IBD patients. He emphasized the need for follow-up analyses to determine how many of the screened positive patients went on to receive a formal SpA diagnosis or other inflammatory arthritis conditions.
Implications for Clinical Practice
The study’s results highlight the necessity for effective strategies to identify IBD patients who would benefit most from rheumatologist consultations. Developing robust screening and risk stratification methods is crucial to ensuring timely and appropriate care for this high-risk group.
Conclusion
This study sheds light on the substantial burden of joint pain among IBD patients and the critical need for improved rheumatological assessment and intervention. It marks an important step towards better understanding and managing the intersection of IBD and SpA, ultimately aiming to enhance patient outcomes through targeted healthcare strategies.
