Prevalence of undiagnosed axial spondyloarthritis in inflammatory bowel disease patients with chronic back pain: secondary care cross-sectional study

Lim, Chong Seng Edwin, Tremelling, Mark, Hamilton, Louise, Kim, Matthew, MacGregor, Alexander ORCID: https://orcid.org/0000-0003-2163-2325, Turmezei, Tom and Gaffney, Karl ORCID: https://orcid.org/0000-0002-7863-9176 (2023) Prevalence of undiagnosed axial spondyloarthritis in inflammatory bowel disease patients with chronic back pain: secondary care cross-sectional study. Rheumatology, 62 (4). pp. 1511-1518. ISSN 1462-0324

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Abstract

Objective: To elucidate the prevalence of undiagnosed rheumatology-verified diagnosis of axial spondyloarthritis (RVD-axSpA) in patients attending routine secondary care IBD clinics with chronic back pain.   Methods: Screening questionnaires were sent to consecutive patients attending IBD clinics in a university teaching hospital. Patients fulling the eligibility criteria (gastroenterologist-verified diagnosis, 18–80 years old, biologic therapy naive, no previous diagnosis of axSpA); and a moderate diagnostic probability of axSpA [self-reported chronic back pain (CBP) >3 months, onset <45 years] were invited for rheumatology assessment. This included medical review, physical examination, patient reported outcome measures, human leucocyte antigen B27, C-reactive protein, pelvic radiograph and axSpA protocol magnetic resonance imaging. A diagnosis of RVD-axSpA was made by a panel of rheumatologists.   Results: Of the 470 patients approached, 91 had self-reported CBP >3 months, onset <45 years, of whom 82 were eligible for clinical assessment. The prevalence of undiagnosed RVD-axSpA in patients attending IBD clinics in a secondary care setting, with self-reported CBP, onset <45 years is estimated at 5% (95% CI 1.3, 12.0) with a mean symptom duration of 12 (S.D. 12.4) years.   Conclusion: There is a significant hidden disease burden of axSpA among IBD patients. Appropriate identification and referral from gastroenterology is needed to potentially shorten the delay to diagnosis and allow access to appropriate therapy.

Item Type:	Article
Additional Information:	Funding Information: 2020 EULAR European E-Congress of Rheumatology [31] and the ACR Convergence 2020 [32]. The National Axial Spondyloarthritis Society (NASS, CT3557/17/E11) and The Norfolk and Norwich Hospital Charity (37996/17/F110).
Uncontrolled Keywords:	axial spondyloarthritis,back pain,epidemiology,inflammatory bowel disease,magnetic resonance imaging,rheumatology,pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/2700/2745
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	22 May 2023 14:30
Last Modified:	27 Nov 2024 10:40
URI:	https://ueaeprints.uea.ac.uk/id/eprint/92122
DOI:	10.1093/rheumatology/keac473

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