Clinical and patient reported outcomes of the multidisciplinary management in patients with inflammatory bowel disease-associated spondyloarthritis

Luchetti, Michele Maria; Benfaremo, Devis; Bendia, E.; Bolognini, Laura; Fava, Giammarco; Marini, Francesco; Sario, A. Di; Ciferri, Monia; Nicola, F Di; Marconi, Valentina; Perini, Lucia; Manfredi, Lucia; Pomponio, Giovanni; Mosca, Piergiorgio; Benedetti, Antonio; Gabrielli, Armando

doi:10.1016/j.ejim.2019.04.015

Cited by 16 publications

(20 citation statements)

References 31 publications

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“…Also, inflammation must be clearly present and located in a typical area (subchondral bone), and the MRI appearance must be highly suggestive of SpA (72). Despite these requirements, the MRI findings are still non-specific, as both the sensitivity and specificity of the sacroiliac joint findings show limitations, and may lead to misclassification in both directions, with missed patients as well as excess diagnoses of SpA (73,74). MRI lesions in patients with SpA may fluctuate, thus lower the sensitivity for diagnostic purposes.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Ankylosing Spondylitis and Axial Spondyloarthritis in Patients With Long-term Inflammatory Bowel Disease: Results From 20 Years of Follow-up in the IBSEN Study

Ossum

Palm

Lunder

et al. 2017

Journal of Crohn's and Colitis

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Ankylosing Spondylitis and Axial Spondyloarthritis in Patients With Long-term Inflammatory Bowel Disease: Results From 20 Years of Follow-up in the IBSEN Study

Ossum

Palm

Lunder

et al. 2017

Journal of Crohn's and Colitis

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“…EIMs have been defined as "an inflammatory pathology in a patient with IBD that is located outside the gut and for which the pathogenesis is either dependent on extension/translocation of immune responses from the intestine, or is an independent inflammatory event perpetuated by IBD or that shares a common environmental or genetic predisposition with IBD." 5 EIMs are common in both ulcerative colitis (UC) 6 and Crohn's disease (CD).…”

mentioning

confidence: 99%

“…Multidisciplinary integrated management plans in IBD practices can improve patient outcomes, as well as quality of life. 6…”

mentioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

et al. 2021

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Inflammatory bowel diseases (IBDs) are systemic diseases that manifest not only in the gut and gastrointestinal tract, but also in the extraintestinal organs in many patients. The quality of life for patients with IBD can be substantially affected by these extraintestinal manifestations (EIMs). It is important to have knowledge of the prevalence, pathophysiology, and clinical presentation of EIMs in order to adapt therapeutic options to cover all aspects of IBD. EIMs can occur in up to 24% of patients with IBD before the onset of intestinal symptoms, and need to be recognized to initiate appropriate diagnostic procedures. EIMs most frequently affect joints, skin, or eyes, but can also affect other organs, such as the liver, lung, and pancreas. It is a frequent misconception that a successful therapy of the intestinal inflammation will be sufficient to treat EIMs satisfactorily in most patients with IBD. In general, peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum can be associated with active intestinal inflammation and can improve on standard treatment of the intestinal inflammation. However, anterior uveitis, ankylosing spondylitis, and primary sclerosing cholangitis usually occur independent of disease flares. This review provides a comprehensive overview of epidemiology, pathophysiology, clinical presentation, and treatment of EIMs in IBD.

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“…In terms of effectiveness, data seem to show that MD working improves the quality of care in SpA by a better identification and diagnosis, [20][21][22][23][24][25][26][27] an earlier and more comprehensive treatment approach 23,24,32 and better outcomes for patients in terms of disease activity, physical function or QoL, 18,19,25,28,29,31 as well as healthcare service utilization and patient satisfaction. 23…”

Section: Effectiveness Of MD Care Compared With Unidisciplinary Care mentioning

confidence: 99%

“…24 Some studies assessed therapeutic adjustment, especially when starting a synthetic or biologic disease-modifying antirheumatic drug. 23,24,26,32 Patient-reported outcomes (PROs) have frequently been reported in studies of MD working in SpA, in particular quality of life (QoL) 18,19,25,29 and patient global assessment, 18,19,25 and more rarely, global wellness, 19 activity limitations and participation restrictions, 29 reinforcing patient centricity.…”

Section: Outcomes and Outcome Measures Evaluated In Studies On MD Wormentioning

confidence: 99%

Multidisciplinary working in the management of axial and peripheral spondyloarthritis

Gudu

Jadon

2020

Therapeutic Advances in Musculoskeletal

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Multidisciplinary (MD) care is essential in the management of patients with spondyloarthritis (SpA) and is one of the main pillars of disease management and patient care. However, evidence supporting the effectiveness and benefits of this strategy in SpA is scarce. In this review we discuss the three types of MD care models: (i) combined clinics (MD units), including ‘face to face’, ‘parallel’ and ‘circuit approach’ clinics; (ii) MD team meetings; (iii) group consultations. The most frequently used model in SpA studies has been the ‘parallel’ combined clinic and usually encompasses a rheumatologist and another specialist, most commonly a dermatologist or a gastroenterologist, that work in tandem according to predefined referral criteria and treatment algorithms. MD working seems to improve the care of patients with SpA by a better identification and diagnosis of the disease, an earlier and more comprehensive treatment approach, and better outcomes for patients in terms of disease activity, physical function, quality of life and patient satisfaction. Nevertheless, challenges remain. Data on effectiveness and feasibility are scarce and are mostly derived from studies with design issues and often without a unidisciplinary care comparator arm. Although patient centricity is one of the core values of patient care and MD setting in SpA, the patient often does not play an active role in most of the MD settings studied or in common clinical practice. Further efforts should be made so that MD care reflects patients’ expectations and needs. Overcoming these limits will help to implement successfully SpA MD care in daily clinical practice and subsequently to achieve a higher quality of care for our patients.

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Clinical and patient reported outcomes of the multidisciplinary management in patients with inflammatory bowel disease-associated spondyloarthritis

Cited by 16 publications

References 31 publications

Ankylosing Spondylitis and Axial Spondyloarthritis in Patients With Long-term Inflammatory Bowel Disease: Results From 20 Years of Follow-up in the IBSEN Study

Ankylosing Spondylitis and Axial Spondyloarthritis in Patients With Long-term Inflammatory Bowel Disease: Results From 20 Years of Follow-up in the IBSEN Study

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

Multidisciplinary working in the management of axial and peripheral spondyloarthritis

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