Clinical management of rheumatologic conditionsco-occurring with inflammatory bowel diseases.

CLINICAL MANAGEMENT OF RHEUMATOLOGIC CONDITIONSCO-OCCURRING WITH INFLAMMATORY BOWEL DISEASES. Expert Rev Clin Immunol. 2018 Aug 17;: Authors: Felice C, Pugliese D, Papparella LG, Pizzolante F, Onori E, Gasbarrini A, Rapaccini GL, Guidi L, Armuzzi A Abstract INTRODUCTION: Spondyloarthritis (SpA) is the most common extra-intestinal manifestation in patients with inflammatory bowel diseases (IBD). Articular disorders may also appear as "paradoxical" effects during biologic therapy with anti-tumor necrosis factor (TNF). Areas covered: In this narrative review, we report the current knowledge about the pathogenesis, the diagnosis and the therapeutic management of articular diseases occurring in patients with IBD. Expert commentary: Evidence-based recommendations for the management of IBD-associated SpA and paradoxical arthritis are lacking. Then, collaboration between gastroenterologists and rheumatologists is mandatory to guarantee the best outcomes for these patients, from a prompt diagnosis to an appropriate therapeutic strategy. Among therapies currently available, steroids, sulfasalazine, methotrexate and anti-TNFs are recommended for both gastrointestinal and articular diseases, whereas non-steroidal anti-inflammatory drugs (NSAIDs) and etanercept are contraindicated in IBD. Thiopurines are not effective for the treatment of articular symptoms. Several agents have been recently introduced for the treatment of IBD, such as vedolizuma...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research