Dactylitis, enthesitis, anterior uveitis occur less frequently in IBD-SpA
Compared with other types of spondyloarthritis (SpA), SpA associated with inflammatory bowel disease (IBD-SpA) has significantly less frequency of dactylitis, enthesitis and anterior uveitis (AU), a recent study has found.
A 12-month case-control study was conducted to examine the frequency of dactylitis, enthesitis and AU in IBD-SpA compared with other SpA, and to assess the role of associated psoriasis in the occurrence of dactylitis and enthesitis.
Researchers compared the frequency of dactylitis and enthesitis in 29 patients with ulcerative colitis (UC) and 59 with Crohn’s disease (CD) who satisfied the Spondyloarthritis International Society criteria for axial or peripheral SpA with 176 controls, including 97 (55.1 percent) with psoriatic arthritis (PsA), 47 (26.7 percent) with ankylosing spondylitis (AS) and 32 (18.2 percent) with nonradiographic axial SpA (nr-axSpA). They also assessed the occurrence of these features in IBD-SpA with and without psoriasis.
Axial involvement was recorded in 46 (52 percent) patients, peripheral involvement in 29 (33 percent) and mixed involvement in 13 (15 percent); 14 out of 88 (16 percent) patients had psoriasis. Dactylitis was observed in four (4.5 percent) patients with IBD-SPA and in 30 controls (17.4 percent; p=0.008), enthesitis in 16 cases (18.1 percent) and in 78 controls (44.3 percent; p<0.001), and AU in three (3.4 percent) patients with IBD-SpA and in 26 controls (14.7 percent; p=0.01).
There were no significant differences between patients with UC-SpA and those with CD-SpA. Dactylitis and enthesitis were significantly more common in patients with IBD-SpA who also had psoriasis vs those without skin disease (p=0.009 and p=0.003, respectively).
“Given the frequent association of psoriasis and IBD, overlooking coexistent skin disease may lead to overestimating the frequency of these features,” researchers said.