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Spondyloarthritis and inflammatory bowel disease

Comorbidity and treatment implications

Spondylarthritis und chronisch entzündliche Darmerkrankungen

Komorbidität und Implikationen für die Therapie

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Abstract

Spondyloarthritides (SpA) and inflammatory bowel disease (IBD) are chronic, idiopathic inflammatory disorders of the axial and peripheral joints and the intestinal tract, respectively, affecting up to 1 % of the population. There is clinical and genetic evidence supporting some degree of overlap between the pathogenesis of these two entities. Nevertheless, their treatment is at times conflicting. NSAIDs, although useful in SpA, are considered to be possible risk factors for flares in IBD. Moreover, etanercept, a soluble TNF receptor blocker used in SpA, is ineffective in IBD. As patients with SpA often develop microscopic gut inflammation, it is important to understand the impact on disease progression or even therapeutic response. Further research is mandatory in this regard.

Zusammenfassung

Spondylarthritiden (SpA) und chronisch entzündliche Darmerkrankungen (CED) sind chronische, idiopathische inflammatorische Störungen der axialen und peripheren Gelenke bzw. des Intestinaltrakts und betreffen etwa 10% der Bevölkerung. Es gibt klinische und genetische Hinweise auf Überlappungen in der Pathogenese dieser beiden nosologischen Entitäten, doch ihre Behandlungen konfligieren bisweilen. Nichtsteroidale Antiphlogistika sind zwar hilfreich in der Behandlung der SpA, doch sie werden auch als mögliche Risikofaktoren für CED-Schübe angesehen. Ferner ist Etanercept, ein bei SpA gegebener löslicher TNF-Rezeptorblocker, nicht wirksam bei CED. Da SpA-Patienten häufig mikroskopisch sichtbare Darmentzündungen entwickeln, ist es wichtig, den Einfluss auf den Erkrankungsprogress oder sogar auf das Therapieansprechen zu verstehen. In diesem Zusammenhang ist weitere Forschung unbedingt erforderlich.

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Conflict of interests

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    G. Varkas, L. Van Praet, H. Cypers &  D. Elewaut MD, PhD

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  1. G. Varkas
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  2. L. Van Praet
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  3. H. Cypers
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  4. D. Elewaut MD, PhD
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Correspondence to D. Elewaut MD, PhD.

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Varkas, G., Van Praet, L., Cypers, H. et al. Spondyloarthritis and inflammatory bowel disease. Z. Rheumatol. 72, 524–529 (2013). https://doi.org/10.1007/s00393-012-1114-5

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