Abstract:
Background. Axial spondylitis (AxSpA) - chronic inflammatory disease of the axial skeleton,
often associated with inflammatory bowel disease (IBD). With an estimated prevalence of
1.5-2%, both share similar immunological mechanisms, and their correlation is essential for
personalized management and better prognosis.
Objective(s).
Evaluation of baseline characteristics, prevalence of inflammatory bowel disease (IBD) and
investigation of correlations between AxSpA and IBD, focusing on demographic, clinical and
genetic factors.
Materials and methods. A prospective observational study conducted on two patient
cohorts: AxSpA (n=257) and IBD, selected from rheumatology and gastroenterology clinics,
meeting the inclusion criteria for axSpA (ASAS) or IBD. Statistical analyses, including multivariable logistic regression, were performed using SPSS v22.0, with significance set at
p<0.05.
Results. Of 257 patients with AS, 13 (5.1%) were diagnosed with IBD, including Crohn's
disease (3.1%), ulcerative colitis (1.2%), and indeterminate colitis (0.8%). The prevalence
of IBD was higher in patients without a family history of AxSpA (7.8% vs. 2.4%, p=0.048)
and increased with disease duration. IBD preceded AxSpA in 53.8% of cases with a mean of
10 years. Extraarticular manifestations: conjunctivitis, nail hyperkeratosis, were present in
43.6% of patients with AxSpA and were associated with a higher prevalence of IBD.
Multivariable analysis identified the absence of a family history of Axial spondylitis as a
significant risk factor for IBD (OR=3.4; p=0.025).
Conclusion(s). The prevalence of IBD in patients with AxSpA emphasizes the need for
integrated monitoring of gastrointestinal symptoms and gastroenterologist-rheumatologist
collaboration, and early detection and management of IBD in patients with AxSpA could
improve overall clinical outcomes and quality of life.
