Abstract:
Introduction. Axial spondylitis is a chronic inflammatory disease primarily affecting the axial skeleton but can also involve
peripheral joints. Axial spondylitis is often associated with extra-articular manifestations, such as inflammatory bowel diseases,
emphasizing the need for rigorous monitoring and personalized therapeutic approaches. The interactions between
axial spondylitis and inflammatory bowel diseases fall under the concept of “immune-mediated inflammatory diseases”,
sharing common pathogenetic mechanisms. This study analyzes the prevalence and characteristics of inflammatory bowel
diseases in patients with axial spondylitis.
Objective. The objective of this study was to describe the baseline characteristics of patients with axial spondylitis, evaluate
the prevalence of inflammatory bowel diseases in this population, and identify correlations between the two conditions,
contributing to a better understanding of their pathogenetic and clinical interactions.
Material and methods. This prospective observational study included 257 axial spondylitis patients followed over two years.
Patients were selected according to ASAS criteria for axial spondylitis and clinical guidelines for inflammatory bowel diseases.
Analyses included clinical evaluations, laboratory tests, and imaging studies. Data were processed using SPSS v22.0. Continuous
variables were expressed as mean ± standard deviation or median and interquartile range, and categorical variables as
percentages. Correlations were assessed using Spearman’s coefficient, with results considered significant at p<0.05.
Results. Among the 257 patients included (168 men and 89 women, mean age 48.2 ± 13.1 years), 13.2% were recently
diagnosed with axial spondylitis. Of these, 5.1% had inflammatory bowel diseases, distributed as follows: Crohn’s disease
(3.1%), ulcerative colitis (1.2%), and indeterminate colitis (0.8%). In 53.8% of cases, the diagnosis of inflammatory bowel
diseases preceded axial spondylitis. Multivariate analysis identified the absence of a family history of axial spondylitis as a
significant risk factor for inflammatory bowel diseases (OR = 3.4; p = 0.025). The prevalence of inflammatory bowel diseases
increased with axial spondylitis duration, reaching 6.5% in patients with disease progression over eight years.
Conclusions. The study highlights a high prevalence of inflammatory bowel diseases in axial spondylitis patients, indicating
the need for rigorous clinical monitoring. The absence of a family history of axial spondylitis was identified as a
major risk factor for inflammatory bowel diseases. These findings emphasize the importance of a multidisciplinary clinical
approach, including active screening for inflammatory bowel diseases and collaboration between rheumatologists and
gastroenterologists, to improve patient prognosis and quality of life.
