Rheumatology International

, Volume 26, Issue 11, pp 953–958

The treatment of the rheumatological manifestations of the inflammatory bowel diseases

  • Melissa Padovan
  • Gabriella Castellino
  • Marcello Govoni
  • Francesco Trotta
Review

DOI: 10.1007/s00296-006-0148-x

Cite this article as:
Padovan, M., Castellino, G., Govoni, M. et al. Rheumatol Int (2006) 26: 953. doi:10.1007/s00296-006-0148-x

Abstract

The strong link between the bowel and the osteo-articular system is suggested by many clinical and experimental observations. However, the therapeutic approach is still empirical. For symptomatic therapy it is better to favour the use of steroids and avoid non-steroidal anti-inflammatory drugs because they may induce intestinal ulcerations and can activate inflammatory bowel disease. Second line drugs (sulfasalazine, methotrexate, azathioprine, cyclosporine and leflunomide) should be used for selected indications. In some cases (severe spondylitis, severe and persistent enthesopathy) anti-TNF-α agents (infliximab) should be considered as first line therapy. In all cases it is mandatory to select the best therapeutic option for each individual patient, considering that the optimal treatment of bowel inflammation may induce “per se” a remission of the musculo-skeletal manifestations.

Keywords

Inflammatory bowel diseases (IBD) Rheumatologic manifestations Therapy Spondyloarthritides Anti-TNF-α agents 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Melissa Padovan
    • 1
  • Gabriella Castellino
    • 1
  • Marcello Govoni
    • 1
  • Francesco Trotta
    • 1
  1. 1.Unit of Rheumatology, Department of Clinical and Experimental MedicineUniversity of Ferrara FerraraItaly

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