Psoriasis and IBD Adversely Impact axSpA Patients’ Disease Activity, Functionality

Patients with axial spondyloarthritis (axSpA) commonly present uveitis, psoriasis, and inflammatory bowel disease (IBD), but data conflict about how any of these three diseases impact activity of musculoskeletal manifestations and functional status. In a new study whose results were presented at the American College of Rheumatology/Empowering Rheumatology Professionals Annual Meeting, its authors looked at the impact of uveitis, psoriasis, and IBD on disease activity and functional status in a population-based cohort of axSpA patients.

The researchers collected health insurance data on a random sample of axSpA patients from Germany who were surveyed on demographic, socioeconomic, and disease-related parameters (including history of the aforementioned conditions). These data were connected to health insurance data that provided recent/current occurrence data of uveitis, psoriasis, and IBD, as well as pharmacological and non-pharmacological treatments. The effects of uveitis, psoriasis, and IBD on disease activity and functional impairment were evaluated, adjusting for confounding factors.

The final analysis included 1,729 axSpA patients (mean age, 55.9 years; 46.1% were female). Overall, recent (ever) uveitis was present in 9% (27%) of patients, while 10% (15%) had recent (ever) psoriasis and 6% (9%) had recent (ever) IBD; 1.6% (6.9%) of the cohort had two of the three conditions present recently (ever), and 0% (0.5%) had all three recently (ever) present. Patients with a history of psoriasis had higher levels of disease activity and functional impairment. IBD history was correlated with higher disease activity, but recent psoriasis and IBD did not largely correlate with disease activity and functional status. A history of uveitis was not significantly correlated with disease activity and functional status, but recent uveitis was largely associated with lower disease activity even when adjusting for treatment.

In their conclusion the researchers speculated that the relationship between recent uveitis and lower disease activity could have something to do with those patients having a higher likelihood of treatment with tumor necrosis inhibitor factors while uveitis was active.