Disease Activity, Functional Impairment in Axial Spondyloarthritis With Psoriasis or Inflammatory Bowel Disease

ATLANTA — Patients with axial spondyloarthritis (axSpA) with a history of inflammatory bowel disease (IBD) or psoriasis may have increased disease activity and functional impairment, whereas history of uveitis displays no major effect, according to research results presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, held November 8 to 13, 2019, in Atlanta, Georgia. However, recent uveitis showed an unexpected association with lower disease activity.

Although uveitis, psoriasis, and IBD are common in axSpA, their effect on musculoskeletal manifestations and functional status remains unclear. Consequently, researchers assessed the differences between patients with and without uveitis, psoriasis, and IBD were assessed in a population-based cohort of 1729 patients with axSpA (mean age, 55.9 years; 46.1% women).

A stratified random sample of patients with axSpA received a survey on demographic, socioeconomic, and disease-related parameters, including history of uveitis, psoriasis, and IBD. Survey data were linked to health insurance data that gathered additional information on recent/current occurrence (within 1 year) of uveitis, psoriasis, and IBD, including drug prescriptions and nonpharmacologic treatment.

After adjustment for other relevant parameters, separate multivariate linear regression models were calculated to determine the effect of uveitis, psoriasis, and IBD on disease activity and functional impairment. Statistical analyses revealed the following prevalence for recent (ever) uveitis, psoriasis, and IBD: 9% (27%) of the patients had recently (ever) uveitis, 10% (15%) had recently (ever) psoriasis, and 6% (9%) had recently (ever) IBD. Furthermore, among 1.6% (6.9%) of patients, 2 of these conditions were recently (ever) present, and in 0% (0.5%) of the patients, all 3 conditions were recently (ever) present.

Researchers concluded that history of IBD was linked with higher disease activity, while history of psoriasis was significantly associated with both higher level of disease activity and functional impairment. However, neither recent IBD nor psoriasis showed a strong association with disease activity and functional status.

History of uveitis showed no strong association with disease activity and functional status, yet recent uveitis was significantly associated with lower disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Redeker I, Callhoff J, Hoffmann F, Haibel H, Sieper J, Zink A, Poddubnyy D. Is there an impact of uveitis, psoriasis and inflammatory bowel disease on musculoskeletal disease activity and function in axial spondyloarthritis? Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. Abstract 579.