Seronegative spondyloarthropathy-associated inflammatory bowel disease  

作　　者：Chrong-Reen Wang Hung-Wen Tsai 

机构地区：[1]Department of Internal Medicine,National Cheng Kung University Hospital,Tainan 70403,Taiwan [2]Department of Pathology,National Cheng Kung University Hospital,Tainan 70403,Taiwan

出　　处：《World Journal of Gastroenterology》2023年第3期450-468,共19页世界胃肠病学杂志（英文版）

基　　金：The institutional review board of National Cheng Kung University Hospital approved this study(No.B-ER-105-108).

摘　　要：Seronegative spondyloarthropathy(SpA)usually starts in the third decade of life with negative rheumatoid factor,human leukocyte antigen-B27 genetic marker and clinical features of spinal and peripheral arthritis,dactylitis,enthesitis and extra-articular manifestations(EAMs).Cases can be classified as ankylosing spondylitis,psoriatic arthritis,reactive arthritis,enteropathic arthritis,or juvenileonset spondyloarthritis.Joint and gut inflammation is intricately linked in SpA and inflammatory bowel disease(IBD),with shared genetic and immunopathogenic mechanisms.IBD is a common EAM in SpA patients,while extraintestinal manifestations in IBD patients mostly affect the joints.Although individual protocols are available for the management of each disease,the standard therapeutic guidelines of SpA-associated IBD patients remain to be established.Nonsteroidal anti-inflammatory drugs are recommended as initial therapy of peripheral and axial SpA,whereas their use is controversial in IBD due to associated disease flares.Conventional disease-modifying anti-rheumatic drugs are beneficial for peripheral arthritis but ineffective for axial SpA or IBD therapy.Anti-tumor necrosis factor monoclonal antibodies are effective medications with indicated use in SpA and IBD,and a drug of choice for treating SpA-associated IBD.Janus kinase inhibitors,approved for treating SpA and ulcerative colitis,are promising therapeutics in SpA coexistent with ulcerative colitis.A tight collaboration between gastroenterologists and rheumatologists with mutual referral from early accurate diagnosis to appropriately prompt therapy is required in this complex clinical scenario.

关 键 词：Seronegative spondyloarthropathy Inflammatory bowel disease BIOLOGICS Anti-tumor necrosis factor monoclonal antibody Small molecules Janus kinases inhibitor 

分 类 号：R574[医药卫生—消化系统]