L.V. IVANOVA¹, E.YU. AKULINUSHKINA¹, S.A. LAPSHINA², D.I. ABDULGANIEVA^2, 3

 ¹Republic Clinical Diagnostic Center, Izhevsk

²Kazan State Medical University, Kazan

³Republic Clinical Hospital, Kazan

 Contact details:

Ivanova L.V. — Chief freelance rheumatologist of the Ministry of Healthcare of Udmurt Republic, Head of the Department of Rheumatology

Address: 87B Lenin St., Izhevsk, Russian Federation, 426000, tel.: +7-912-761-45-57, e-mail: loraivanova7@mail.ru

 Seronegative spondyloarthritis (SpA) (psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA)), inflammatory bowel disease (IBD) and psoriasis form a group of immunoinflammatory diseases (IIDs). The increased risk of developing IBD in patients with IIDs is known and, on the contrary, the risk of skeletal-muscle IIDs in patients with IBD was demonstrated. This indicates the necessity of early diagnosis of IBD in patients with SpA. In connection with this, a screening tool «Universal questionnaire for identifying signs of immunoinflammatory diseases» was developed and put into practice. The article shows the results of the «Universal questionnaire for IIDs» use in rheumatology practice by 140 patients with SpA. It was found that 17.2% patients with PsA and 20.8% with AxSpA required further exclusion of IBD. The need to exclude IBD was equally frequent in patients with PsA and AxSpA. Clinical and laboratory parameters in groups with the alleged IBD did not significantly differ from those in other patients, which confirms the need to introduce the «Universal questionnaire» into the practice for the purpose of early diagnosis of combined IIDs.

Key words: psoriatic arthritis, axial spondyloarthritis, inflammatory bowel disease, immunoinflammatory disease.

REFERENCES

1. Collaborators GBDIBD. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, Lancet. 2020, vol. 5 (1), pp. 17–30. DOI: 10.1016/S2468-1253(19)30333-4
2. Vojvodic A., Peric-Hajzler Z., Matovic D. et al. Gut microbiota and the alteration of immune balance in skin diseases: from nutraceuticals to fecal transplantation. J Med Sci., 2019, vol. 7 (18), pp. 3034–3038. DOI: 10.3889/oamjms.2019.827
3. Brand S. Crohn’s disease: Th1, Th17 or both? the change of a paradigm: new immunological and genetic insights implicate Th17 cells in the pathogenesis of Crohn’s disease. Gut, 2009, vol. 58 (8), pp. 1152–1167. DOI: 10.1136/gut.2008.163667
4. Furiati S.C., Catarino J.S., Silva M.V. et al. Th1, Th17, and Treg responses are differently modulated by TNF-α inhibitors and methotrexate in psoriasis patients. Sci Rep., 2019, vol. 9 (1), p. 7526. DOI: 10.1038/s41598-019-43899-9
5. Haycock P.C., Burgess S., Wade K.H. et al. Best (but oft-forgotten) practices: the design, analysis, and interpretation of Mendelian randomization studies. The American Journal of Clinical Nutrition, 2016, vol. 103 (4), pp. 965–978. DOI: 10.3945/ajcn.115.118216
6. Freuer D., Linseisen J., Meisinger C. Association Between Inflammatory Bowel Disease and Both Psoriasis and Psoriatic Arthritis: A Bidirectional 2-Sample Mendelian Randomization Study. JAMA Dermatol, 2022, vol. 158 (11), pp. 1262–1268. DOI: 10.1001/jamadermatol.2022.3682
7. Loftus E., Augustin M., Bissonnette R. et al. Prevalence of inflammatory bowel disease amongst patients with psoriasis and incidence of serious infections in this subset: results from the PSOLAR Registry. Poster Presentation at European Crohn’s and Colitis Annual Meeting 2016. Epub. P626.
8. Vavricka S.R., Brun L., Ballabeni P. et al. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol., 2011, vol. 106 (1), pp. 110–119. DOI: 10.1038/ajg.2010.343
9. Emond B., Ellis L.A., Chakravarty S.D. et al. Real-world incidence of inflammatory bowel disease among patients with other chronic inflammatory diseases treated with interleukin-17a or phosphodiesterase 4 inhibitors. Curr Med Res Opin, 2019, vol. 35 (10), pp. 1751–1759. DOI: 10.1080/03007995.2019.1620713
10. Abdulganieva D.I., Bakulev A.L., Belousova E.A. et al. Draft interdisciplinary recommendations on the diagnosis, methods for assessing the degree of activity, therapeutic efficacy and the use of genetically engineered biological drugs in patients with combined immunoinflammatory diseases (psoriasis, psoriatic arthritis, Crohn’s disease). Sovremennaya revmatologiya, 2018, no. 12 (3), pp. 4–18 (in Russ.). DOI: 10.14412/1996-7012-2018-3-4-18
11. Coates L.C., Soriano E.R., Corp N., et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis. Nat Rev Rheumatol, 2022, vol. 18 (8), pp. 465–479. DOI: 10.1038/s41584-022-00798-0
12. Ramiro S., Nikiphorou E., Sepriano A. et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Annals of the Rheumatic Diseases, 2023, vol. 82, pp. 19–34.
13. Brüner M., Dige A., Loft A.G., et al. Spondylitis-psoriasis-enthesitis-enterocolitis-dactylitis-uveitis-peripheral synovitis (SPEED-UP) treatment. Autoimmun Rev, 2021, vol. 20 (2). DOI: 10.1016/j.autrev.2020.102731