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. 2012 Nov;39(11):2148-52.
doi: 10.3899/jrheum.120321. Epub 2012 Sep 15.

Incidence of spondyloarthropathy in patients with Crohn's disease: a population-based study

Raina Shivashankar  1 , Edward V Loftus Jr, William J Tremaine, Tim Bongartz, W Scott Harmsen, Alan R Zinsmeister, Eric L Matteson
Affiliations

Incidence of spondyloarthropathy in patients with Crohn's disease: a population-based study

Raina Shivashankar et al. J Rheumatol. 2012 Nov.

Erratum in

  • J Rheumatol. 2012 Nov;39(11):2232

Abstract

Objective: Spondyloarthritis (SpA) is an extraintestinal manifestation of inflammatory bowel disease with significant clinical effects, although the frequency is uncertain. We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort.

Methods: The medical records of a population-based cohort of Olmsted County, Minnesota, residents diagnosed with CD between 1970 and 2004 were reviewed. Patients were followed longitudinally until migration, death, or December 31, 2010. We used the European Spondylarthropathy Study Group, Assessment of Spondyloarthritis international Society (ASAS) criteria and modified New York criteria to identify patients with SpA. The Kaplan-Meier method was used to estimate the cumulative incidence of SpA following diagnosis of CD.

Results: The cohort included 311 patients with CD (49.8% females; median age 29.9 yrs, range 8-89). Thirty-two patients developed SpA based on ASAS criteria. The cumulative incidence of SpA after CD diagnosis was 6.7% (95% CI 2.5%-6.7%) at 10 years, 13.9% (95% CI 8.7%-18.8%) at 20 years, and 18.6% (95% CI 11.0%-25.5%) at 30 years. The 10-year cumulative incidence of ankylosing spondylitis was 0, while both the 20-year and 30-year cumulative incidences were 0.5% (95% CI 0-1.6%).

Conclusion: We have for the first time defined the actual cumulative incidence of SpA in CD using complete medical record information in a population-based cohort. The cumulative incidence of all forms of SpA increased to approximately 19% by 30 years from diagnosis of CD. Our results emphasize the importance of maintaining a high level of suspicion for SpA when following patients with CD.

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Conflict of interest statement

Disclosures: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cumulative incidence (1 minus survival free) of any spondyloarthritis (based on European Spondyloarthropathy Study Group criteria) from Crohn’s disease diagnosis among 307 Olmsted County, Minnesota residents with Crohn’s disease (1970–2004).
Figure 2
Figure 2
Cumulative incidence (1 minus survival free) of any spondyloarthritis (based on Assessment of Spondyloarthritis international Society classification criteria) from Crohn’s disease diagnosis among 298 Olmsted County, Minnesota residents with Crohn’s disease (1970–2004).
See this image and copyright information in PMC

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