SAT0351 IBIS-Q (IBD IDENTIFICATION OF SPONDYLOARTHRYTIS QUESTIONNAIRE): A NEW TOOL TO DETECT SPONDYLOARTHRITIS IN INFLAMMATORY BOWEL DISEASE PATIENTS
Authors: Ilaria Tinazzi, Angela Variol, Antonio Marchetta, Andrea Geccherle, Pierluigi Macchioni, Dennis Mcgonagle
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Extra-intestinal manifestations (EIM) are frequent in IBD with peripheral and axial spondyloarthritis (SpA) being the commonest EIM,being reported in up to 23% of subjects.. Early detection of SpA is clinically relevant to drive the therapeutic management including the right treatment at the right time to prevent disability and improve the quality of life. In the literature there are few validated Rheumatology referral models for SpA for gastroenterological use <h3>Objectives:</h3> The aim of this study was to develop a questionnaire to identify peripheral and axial SpA in a cohort of IBD patients (setting: IBD Unit of Sacro Cuore-Negrar Hospital Verona in a rheumatological-gastroenterology clinic). <h3>Methods:</h3> During a preliminary meeting a group of experts in SpA-IBD (6 rheumatologists and 4 gastroenterologists) generated a list of 42 items thought to cover all possible SpA manifestations including spinal, articular and entheseal involvement. Consecutive patients referred to the IBD Unit were then enrolled from January to May 2018 without excluding patients affected by EIM. Rheumatologic assessment was performed in the same day by a Rheumatologist blinded to the medical story and to the questionnaire results in order to collect data about the 66 swollen joint count (SJC) and 68 TJC, MASEI, LEI, presence of ASAS criteria for axial and peripheral SpA, presence of diagnostic criteria for fibromyalgia (FM) and non-specific low back pain (NSLB) pain mainly due to OA). If the patient presented a tender/swollen entheses, a US exam completed the clinical examination. The patient completed BASDAI and BASFI questionnaires in the same day. Factorial analysis to identify the main factors; ROC curves for sensibility/specificity; Youden index for cut-off were performed. <h3>Results:</h3> A final 38-items questionnaire was tested in 210 patients (excluding 17 patients for presence of other rheumatic diseases and 12 for incomplete evaluation). The psychometric analysis of the questionnaire was done on data of 181 patients. 58 patients of the enrolled patients met the ASAS criteria for SpA (13 axial, 5 both axial and peripheral 40 peripheral). The SpA prevalence in our cohort was 32% with 10 new cases detected by the questionnaire (5.5%: 7 peripheral and 3 axial). Through the psychometric and factorial analysis, we selected 14-items to include in the final questionnaire (named IBIS-Q; Table 1) having a sensitivity 84.4% and specificity 80% to detect SpA (AUC 0.8803 with CI 95% 0.8305- 0.9301). We propose as cut-off of 4 positive questions of the IBIS-Q for SpA patient identification <h3>Conclusion:</h3> IBIS-Q seems to be a useful and simple tool to use in our IBD clinic for the detection of SpA, with a good statistical performance. Further studies are needed to validate this questionnaire <h3>Disclosure of Interests:</h3> Ilaria Tinazzi: None declared, Angela Variol: None declared, Antonio Marchetta: None declared, Andrea Geccherle: None declared, Pierluigi Macchioni: None declared, Dennis McGonagle Consultant for: Lilly, Novartis UCB, Speakers bureau: Lilly, Novartis UCB