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Defining the phenotype, pathogenesis and treatment of Crohn's disease associated spondyloarthritis.

TitleDefining the phenotype, pathogenesis and treatment of Crohn's disease associated spondyloarthritis.
Publication TypeJournal Article
Year of Publication2020
AuthorsKumar A, Lukin D, Battat R, Schwartzman M, Mandl LA, Scherl E, Longman RS
JournalJ Gastroenterol
Volume55
Issue7
Pagination667-678
Date Published2020 Jul
ISSN1435-5922
Abstract

Peripheral and axial spondyloarthritis are the most common extra-intestinal manifestations reported in patients with Crohn's disease. Despite the frequency of Crohn's disease associated spondyloarthritis, clinical diagnostic tools are variably applied in these cohorts and further characterization with validated spondyloarthritis disease activity indexes are needed. In addition, the pathogenesis of Crohn's disease associated spondyloarthritis is not well understood. Evidence of shared genetic, cellular, and microbial mechanisms underlying both Crohn's disease and spondyloarthritis highlight the potential for a distinct clinicopathologic entity. Existing treatment paradigms for Crohn's disease associated spondyloarthritis focus on symptom control and management of luminal inflammation. A better understanding of the underlying pathogenic mechanisms in Crohn's disease associated spondyloarthritis and the link between the gut microbiome and systemic immunity will help pave the way for more targeted and effective therapies. This review highlights recent work that has provided a framework for clinical characterization and pathogenesis of Crohn's disease associated spondyloarthritis and helps identify critical gaps that will help shape treatment paradigms.

DOI10.1007/s00535-020-01692-w
Alternate JournalJ Gastroenterol
PubMed ID32367294
PubMed Central IDPMC7297835
Grant ListR01 DK114252 / DK / NIDDK NIH HHS / United States
R01 DK120985 / DK / NIDDK NIH HHS / United States