Norwegian researchers looked at the long-term prevalence of inflammatory back disorders in patients with IBD-and identified a predisposing factor.
Norwegian researchers looked at the long-term prevalence of inflammatory back disorders in patients with IBD-and identified a predisposing factor. Click through the slides for the results of their 20-year follow-up.
1. Ossum AM, Palm Ã, Lunder AK, et al. Ankylosing spondylitis and axial spondyloarthritis in patients with long-term inflammatory bowel disease: results from 20 years of follow-up in the IBSEN Study. J Crohns Colitis. 2018;12:96-104. doi: 10.1093/ecco-jcc/jjx126
The most common extraintestinal symptoms of inflammatory bowel disease (IBD) are musculoskeletal, especially spondyloarthritis. Inflammatory back disorders typically occur early in the course of IBD. However, their prevalence late in IBD is not well known.
What is the prevalence of inflammatory back disorders 20 years after the diagnosis of IBD? How are these disorders associated with IBD severity? A team of Norwegian researchers addressed these questions in the IBSEN Study.
The IBSEN Study, a population-based prospective cohort study in Norway, included 314 patients with ulcerative colitis and 156 with Crohn's disease.1
At 20-year follow-up, a high prevalence of inflammatory back disorders was found in patients with IBD. Most of back disorders had been diagnosed within 5 years of the IBD diagnosis.
Note that axial spondyloarthritis is associated with more chronic, active IBD.
HLA-B27 was significantly associated with axial spondyloarthritis, ankylosing spondylitis, and inflammatory back pain (P ≤ .01). NOD2 genetic polymorphisms were not significantly linked to back disorders.
Results from this and other studies suggest that inflammatory back pain occurs in 2 out of 5 patients with IBD. The high prevalence of HLA-B27 in IBD patients with ankylosing spondylitis, axial spondyloarthritis, and inflammatory back pain confirms that it predisposes to inflammatory back disorders. Chronic, active IBD was the only disease factor linked to inflammatory back disorders, and was associated with axial spondyloarthritis.
What can be gleaned from this Norwegian study? These key points:
• There is a high prevalence of ankylosing spondylitis, axial spondyloarthritis, and inflammatory back pain 20 years after IBD is diagnosed
• HLA-B27 but not NOD2 is a predisposing factor for inflammatory back disorders in IBD
• Axial spondyloarthritis is associated with a more chronic, active IBD disease course