Journal Article

PO:01:015a | Evaluation of the impact of concomitant psoriasis on the clinical and therapeutic pattern of a monocentric cohort of patients affected by spondyloarthritis associated with inflammatory bowel diseases

Società Italiana di Reumatologia

2025

Overview

Background. To evaluate the influence of concomitant psoriasis (PsO) on the clinical and therapeutic pattern of a monocentric cohort of patients affected by Spondyloarthritis (SpA) associated with inflammatory bowel diseases (IBD). Materials and Methods. This study represents a preliminary phase of an ancillary analysis of the DIAMANTE project (Early diagnosis of spondyloarthritis in a cohort of patients affected by inflammatory bowel disease), developed with the general objective of determining the prevalence, predictors, and outcomes of SpA in a cohort of IBD patients, within the context of a close and structured collaboration between gastroenterologists and rheumatologists. Within the DIAMANTE cohort, two subgroups of patients were identified for the study: patients with enteropathic SpA and a concomitant personal diagnosis of PsO (Group 1: IBD+SpA+PsO), and patients with a diagnosis of SpA only (Group 0: IBD+SpA). For both groups, the following demographic, clinical, and therapeutic data were recorded and compared: sex, association with IBD pattern, peripheral joint involvement, axial involvement, history of dactylitis, need for biologic therapy, and multi-resistance to “targeted” drugs (defined as discontinuation due to inefficacy of at least two biologic drugs or small molecules). A p-value <0.05 was considered statistically significant using Fisher’s exact test and the Chi-square test. Results. Data from 665 consecutive patients with IBD recruited between November 2023 and April 2025 were analyzed. Within this cohort, 95 (14%) had a concomitant diagnosis of SpA; among these, 21 (22%) also had a diagnosis of PsO (Group IBD+SpA+PsO), while 74 (78%) had only SpA associated with IBD (Group IBD+SpA). Comparative analysis between the two groups showed notable—though only trending toward statistical significance—differences in terms of female prevalence (71% vs 54%, p=0.15), frequency of peripheral involvement (62% vs 49%, p=0.28), and use of biologic drugs (91% vs 77%, p=0.17). Most notably, a significantly higher frequency of multi-resistance to biologic treatment was observed in patients with concomitant PsO compared to those with IBD and SpA only (29% vs 11%, p=0.04). No significant differences were observed regarding the distribution of different IBD types (ulcerative colitis, Crohn’s disease, indeterminate forms) between the two study groups. Conclusions. In patients with SpA associated with IBD, a frequent concomitant association with PsO—another extra-articular domain typical of the spondyloenthesitis spectrum—was demonstrated. The results of this exploratory analysis suggest the usefulness of further investigating, in larger prospective cohorts, the impact that such a dual combination of extra-articular manifestations may have on disease characteristics and, in particular, on therapeutic management.

• Publisher: PAGEPress Publications
• Subject: enteropathic SpA / IBD / psoriasis