Management of arthropathy in inflammatory bowel diseases

Therapeutic Advances in Chronic Disease
Rosario PelusoMatteo Nicola Dario Di Minno

Abstract

The most common extra-intestinal manifestation in patients with inflammatory bowel disease (IBD) is articular involvement, with a prevalence ranging between 17% and 39%. It is frequently characterized by an involvement of the axial joints but may also be associated with peripheral arthritis. The target of therapy in the management of arthritis associated with IBD is to reduce the inflammation and prevent any disability and/or deformity. This requires active cooperation between gastroenterologist and rheumatologist. The treatment of axial involvement has focused on the combination of exercise with nonsteroidal anti-inflammatory drugs. Immunomodulators have been efficacious in patients with peripheral arthritis and other extra-intestinal manifestations, but they are not effective for the treatment of axial symptoms of spondylitis. Tumor necrosis factor (TNF) α inhibitors have been proven to be highly effective in the treatment of IBD patients which are steroid-dependent or refractory to conventional therapy and in patients with associated articular manifestations. The treatment of peripheral involvement and/or enthesitis and/or dactylitis is based on local steroid injections, while sulfasalazine and/or low doses of systemic stero...Continue Reading

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Citations

Jun 21, 2016·Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology·Yuki NankeShigeru Kotake
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Nov 27, 2020·Modern Rheumatology Case Reports·Matthew ColquhounMaria Mouyis

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Methods Mentioned

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imaging technique
X-ray

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