SAT0342 RISK FACTORS FOR ARTHROPATHY IN ULCERTIVE COLITISPATIENTS AFTER TOTAL COLECTOMY; A RETROSPECTIVE, A SINGLE CENTER STUDY
Authors: Kentaro Noda, Yuki Mizutani, Naohiro Sugitani, Yasuo Suzuki, Toshimitsu Araki, Masato Kusunoki, Ayako Nakajima
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Ulcertive colitis (UC) is associated with a variety of extraintestinal manifestations (EIMs) that may have negative effects on performance status and quality of life. EIMs frequently affect musculoskeltal systems (peripheral and axial arthropathies), skin, hepatobiliary tract and eyes<sup>1,2</sup>. Previous studies showed that peripheral and axial arthropathies were seen 4-23% patients with UC and they tend to have peripheral rather than axial arthropathies<sup>3</sup>. UC is generally thought to become in remission when patients undergo total colectomy. However, in clinical practice, patients often suffered from arthropathy which is thought as EIMs even after total colectomy. The distribution and risk factors for the occurrence of peripheral and axial arthropathies among UC patients after total colectomy have not been investigated yet. <h3>Objectives</h3> In this study, we aimed to clarify frequency and distribution of arthropathy and to investigate risk factors for developing arthropathy among UC patients after colectomy. <h3>Methods</h3> In this retrospective, single center, observational study, we investigated the backgrounds and risk factors for arthropathy using patients underwent total colectomy from January 2007 to February 2016 in Mie University. As backgrounds, age, sex, presence and distribution of arthropathy, other EIMs, and duration after colectomy, clinical activity (mild/moderate/severe), Matts classification (grade 1+2 vs 3+4), presence of massive hemorrhage and toxic megacolon, previous therapies for UC were collected from electronic medical records. Arthropathy was defined as joint pain or swelling without definite cause which was improved by using glucocorticoid. Background factors were described as median (IQR) for continuous variables or as percentage (%) for categorical variables and difference was analyzed by Wilcoxon for continuous variables and by chi-square for categorical variables. Factors with p-value &lt; 0.1 in univariate analyses were included in multivariate logistic regression analysis for risk of developing arthropathy. <h3>Results</h3> We enrolled 219 patients (female; 40.2% and median age at operation; 38.0 [27.0, 53.0] years). Among them, 40 (18.3%) patients had arthropathy, peripheral type in 23 (57.5%), axial type in 3 (7.5%), mixed type in 14 (35.0%). Duration from operation to onset of arthropathy was 0.7 [0.4, 1.2] years. The risk factors for developing arthropathy by univariate analyses were Matts classicification (grade 3+4 vs 1+2) (p &lt; 0.05), follow up periods (p &lt; 0.001), presence of other EIMs (p &lt; 0.001), ileal pouchitis (p &lt; 0.01), but previous treatment of biologics was not significant (p = 0.84). Table 1 showed the risk factors for developing arthropathy by multivariate logistic regression analysis using age, sex, Matts classicification, follow up period, presence of other EIMs and ileal pouchitis. Follow up period [OR 1.17 (95% CI 1.03-1.33, p &lt; 0.05)], Matts classicification [OR 2.61 (95% CI 1.19-5.74, p &lt; 0.05)] and ileal pouchitis [OR 2.65 (95% CI 1.16-6.07, p &lt; 0.05)] were significantly associated with an increased risk of developing arthropathy of UC patients after colectomy. <h3>Conclusion</h3> About one fifth patients with UC who underwent colectomy developed arthropathy presenting predominantly peripheral type. Long follow up period, High disease activity by endoscopic classification, and ileal pouchitis were risk factors of developing arthropathy in UC patients after total colectomy. The frequency and risk factors for developing arthropathy even after colectomy was demonstrated in this study for the first time. <h3>References</h3> [1] Paraskevi VV, et al. Ann Gastroenterol. 2011; 24: 173-80. [2] Orchard TR, et al. Gut. 1998; 42: 387–91. [3] Das KM, et al. Dig Dis Sci1999;44:1–13. <h3>Disclosure of Interests</h3> Kentaro Noda: None declared, Yuki Mizutani: None declared, Naohiro Sugitani: None declared, Yasuo Suzuki: None declared, Toshimitsu Araki: None declared, Masato Kusunoki Grant/research support from: Chugai Pharmaceutical Co., Shionogi Pharmaceutical Co., Taiho Pharmaceutical Co., and Mitsubishi Tanabe Pharma Co., Ayako Nakajima Grant/research support from: Asahi Kasei pharma co., Chugai Pharmaceutical, Daiichi Sankyo Co., Pfizer, Kissei Pharmaceutical Co., and Mitsubishi Tanabe Pharma Corporation.