Assessment of response of Enteropathic Spondyloarthritis to different types of biological therapy; an Egyptian single center study

Fatma Abozeid, Mansoura University Faculty of MedicineFollow
Marwa Besar, Mansoura University Faculty of Medicine

Corresponding Author

Fatma Abozeid

Subject Area

Hepatology and GIT

Article Type

Original Study

Abstract

Introduction: Arthropathy is one of the most prevalent extraintestinal symptoms of inflammatory bowel disease (IBD). It may be either peripheral or axial spondyloarthropathy. Biological treatment as anti-tumor necrosis factor alpha (TNF𝛼) or anti-interleukin 12/23 (anti IL 12/23) have shown efficacy in controlling gut inflammation and reducing joint manifestation. Our aim of the study was to assess the different aspects of response (laboratory , endoscopically and radiologically) of axial arthropathy associated with IBD patients after receiving biological drugs including: anti TNF (infliximab and adalimumab)& anti IL 12/23 (ustekinumab)

Patients & methods:A single center observational study was conducted through one year duration from June 2022 till June 2023. Out of 650 patients with IBD- who attended IBD clinic at Mansoura Specialized Medical Hospital ,122 patients had arthritis as one of extra-intestinal manifestation of IBD. A group of 25 patients of enteropathic axial arthropathy were selected according to inclusion criteria and their data were analyzed.

Results: Prevalence of arthritis in IBD represents 18.8%. Axial arthropathy prevalence among IBD cases was 3.38% and among IBD patients with arthritis was 18%. While ankylosing spondylitis prevalence was 0.46% among IBD cases and 2.45% among IBD cases with arthritis. Fourteen patients (56%) started biological treatment while rest were on conventional therapy. We found significant improvement as regard hemoglobin, serum albumin, C-reactive protein and fecal calprotectin under biological treatment (p˂0.05).There was significant improvement in terms of endoscopic score (MAYO for UC P=0.006 and CDAI for CD P=0.034) pre and post biological. There was significant decline as regard the grade of inflammation at the axial sacroiliac joint by MRI after receiving biological treatment (P= 0.0001).

Conclusion: Biological therapy should be considered early in axial arthropathy associated with IBD. Anti TNF should be considered as first line of therapy in these cases.

Recommended Citation

Abozeid, Fatma and Besar, Marwa (2024) "Assessment of response of Enteropathic Spondyloarthritis to different types of biological therapy; an Egyptian single center study," Mansoura Medical Journal: Vol. 53 : Iss. 2 , Article 5.
Available at: https://doi.org/10.58775/2735-3990.1420