Inflammatory Bowel Disease Related Joint Manifestations

Inflammatory Bowel Disease Related Joint Manifestations Including the Incidence, Types, Relation to Disease Activity and Types of Treatment

The main purpose of this research is to identify incidence of jiunt manifestations by its both types axial and periphral in IBD patients, its types , relation to IBD activity, lines of treatment using and how they are effective in prevention and in treatment of these joint manifestations.

Study Overview

• Status: Not yet recruiting
• Conditions: Joint Diseases; IBD

Detailed Description

Inflammatory bowel disease (IBD) is a chronic immune-mediated disorder divided into two large types Crohn disease and ulcerative colitis. Crohn disease may affect any part of the gastrointestinal tract (GIT), whereas Ulcerative colitis affects the large intestine . IBD is also described to cause remissions and relapses or activity. IBD is a multisystem condition that affects mainly the gastrointestinal, musculoskeletal, ocular, and cutaneous systems. Those complications that arise outside the intestinal inflammation are known as extra intestinal manifestations (EIMs) of IBD, EIMs present in 5% to 50% of all IBD patients these may be :skin, eyes, kidneys, liver, anaemia.

In a focused point musculoskeletal manifestations being the most common EIM with a incidence about 40%. It was divided into:

A. Axial type (spondyloarthropathy) B. Peripheral type divided into : 1.Type 1 (pauciarticular). 2.Type 2 (polyarticular) In this research we shall focus on the confirmed data for diagnosis of IBD by history , lab investigations & colonoscopy and biopsy including disease location . Then onset of joint manifestations in relation to both intestinal & other extra intestinal manifestations . The effect of disease activity on routine lab investigations including CBC, kidney function , liver function , ESR, CRP & on imaging like x-ray .

Also the effect of disease activity on joint manifestations is an important point to be discussed .

For this purpose, a validated detailed questionnaire according to farisoğullari 2021 consisting of six questions was asked (1). Have you ever had swelling or pain in fingers , toes or any other joint with no apparent reason? (2).Has an entire finger or toe becomes swollen, making it look like a 'sausage' ? (3). Have you had pain in your heels? (4). Have you ever had back pain lasting at least 3 months that was not injury related? (5). Do you have low back pain in the morning after resting that improves with exercise? (6). Do you wake up at night because of low back pain?.

The response of joint manifestations to different routes of treatment of IBD is also of great importance , A good response of back pain to a full dose of non-steroidal anti-inflammatory drugs was defined as "not anymore present "or "much better". Immunomodulators have been efficacious in patients with peripheral arthritis and other extra-intestinal manifestations, but they are not effective for the treatment of axial symptoms of spondylitis.

The treatment of peripheral involvement and/or enthesitis and/or dactylitis is based on local steroid injections, while sulfasalazine and/or low doses of systemic steroids may be useful in case of inadequate response to intra-articular steroids. Sulfasalazine induces only a little improvement in peripheral arthritis. Immunomodulators such as methotrexate, azathioprine, cyclosporine and leflunomide were also effective.

• Study Type: Observational
• Enrollment (Anticipated): 217

Contacts and Locations

• Study Contact: Name: Youstina soliman, doctor; Phone Number: 01286515639; Email: youstinayosry.55@gmail.com
• Study Contact Backup: Name: nabawia tawfik, prof doctor; Phone Number: 01223971418; Email: Nabawia.tawfik@yahoo.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 90 years (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients with inflammatory bowel disease attending IBD clinic in EL-RAGHY LIVERHOSPITAL.

Description

Inclusion Criteria:

• Patients previously diagnosed by colonoscopy and biopsy of IBD either crhons disease or ulcerative colitis from2017 to 2022 attending IBD clinic in EL-RAGHY LIVERHOSPITAL.

Exclusion Criteria:

• Patients with a known diagnosis of any other joint disease like:

  1. autoimmune disease like SLE , RA , psoriasis
  2. Osteoarthritis
  3. Gouty arthritis
  4. Malignancy
  5. Polymyalgia rheumatica

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The joint manifestations in Inflammatory bowel disease patients.	The main purpose of this research is to identify incidence of joint manifestations by its both types axial and peripheral in crohns disease and ulcerative colitis patients, relation to the disease activity,other extra intestinal manifestations, lines of treatment used and how they are effective in prevention and in treatment of these joint manifestations.	2017 to 2024

Collaborators and Investigators

• Sponsor: Youstina Yosry Soliman
• Investigators: Study Director: Mohamed Ali, ass.prof doc, Assiut Univeristy

Publications and helpful links

General Publications

• Voulgari PV. Rheumatological manifestations in inflammatory bowel disease. Ann Gastroenterol. 2011;24(3):173-180.
• Fragoulis GE, Liava C, Daoussis D, Akriviadis E, Garyfallos A, Dimitroulas T. Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment. World J Gastroenterol. 2019 May 14;25(18):2162-2176. doi: 10.3748/wjg.v25.i18.2162.
• Di Carlo M, Luchetti MM, Benfaremo D, Di Donato E, Mosca P, Maltoni S, Benedetti A, Gabrielli A, Grassi W, Salaffi F. The DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire: development and preliminary testing of a new tool to screen patients with inflammatory bowel disease for the presence of spondyloarthritis. Clin Rheumatol. 2018 Apr;37(4):1037-1044. doi: 10.1007/s10067-017-3937-6. Epub 2017 Dec 4.

Study record dates

Study Major Dates

• Study Start (Anticipated): March 1, 2023
• Primary Completion (Anticipated): December 31, 2024
• Study Completion (Anticipated): March 1, 2025

Study Registration Dates

• First Submitted: December 24, 2022
• First Submitted That Met QC Criteria: January 12, 2023
• First Posted (Actual): January 20, 2023

Study Record Updates

• Last Update Posted (Actual): January 20, 2023
• Last Update Submitted That Met QC Criteria: January 12, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Keywords: IBD; periphral and axial spondylopathy
• Additional Relevant MeSH Terms: Digestive System Diseases; Gastrointestinal Diseases; Musculoskeletal Diseases; Gastroenteritis; Intestinal Diseases; Inflammatory Bowel Diseases; Joint Diseases
• Other Study ID Numbers: Joint manifestations in IBD

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No