BERLIN – The cumulative incidence of spondyloarthropathy in the first decade after diagnosis of inflammatory bowel disease is about 1 in 50 patients, climbing to 1 in 25 at 20 years and 1 in 14 at 30 years, according to the first population-based study to scrutinize the issue.
The incidence of spondyloarthropathy following diagnosis of ulcerative colitis is about half that seen in Crohn’s disease patients, said Dr. Eric L. Matteson at the Annual European Congress of Rheumatology.
Dr. Matteson, a professor of medicine and chair of the department of rheumatology at the Mayo Clinic, Rochester, Minn., and his coinvestigators analyzed the medical records of Olmsted County, Minn., residents who had been diagnosed with inflammatory bowel disease (IBD) during 1970-2004. The 311 patients diagnosed with Crohn’s disease and 365 with ulcerative colitis were followed longitudinally through June 2011. The median age at diagnosis of IBD was 33 years.
The prevalence of diagnosed spondyloarthropathy prior to diagnosis of IBD was 1%. The cumulative incidence of spondyloarthropathy following an established IBD diagnosis was 2.3% at 10 years, 4.2% at 20 years, and 7.1% at 30 years. The overall cumulative incidence of ankylosing spondylitis was 0.2% at 10 years, rising to 0.7% at 20 years.
The 10-, 20- and 30-year cumulative incidence rates for spondyloarthropathy after diagnosis of Crohn’s disease were 2.6%, 6.1%, and 9.8%, respectively, as compared with 1.9%, 2.8%, and 4.9% following diagnosis of ulcerative colitis.
Clinical features of spondyloarthropathy that appeared only after diagnosis of IBD included oligoarthritis in 3.1%, polyarthritis in 1.3%, sacroiliitis in 1.6%, psoriasis in 2.2%, uveitis in 2.9%, and plantar fasciitis in 5%.
Dr. Matteson reported having no financial conflicts.