SAT0443 CONCOMITANT PSORIATIC ARTHRITIS AND INFLAMMATORY BOWEL DISEASE IN THE PSA BIOLOGICAL REGISTRY: HUR-BIO REAL LIFE RESULTS
Authors: G. K. Yardimci, B. Farisoğullari, B. Armagan, E. Bilgin, E. C. Bolek, E. Duran, L. Kiliç, O. Karadag, A. Akdoğan, Ş. A. Bilgen, A. İ. Ertenli, S. Kiraz, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with spondyloarthritis (SpA) have 3 important extra-articular involvement; psoriasis, uveitis and inflammatory bowel disease (IBD). Psoriatic arthritis (PsA) patients may have IBD, as well, and clinical features of PsA + IBD patients do not assess comprehensively, yet. Objectives: The purpose of this study is to determine the frequency and clinical features of concomitant PSA and IBD in a PsA biological DMARD cohort. Methods: Hacettepe University Rheumatology Biologic (HUR-BIO) is a single center biologic registry since 2005 and include 469 psoriatic arthritis patients to date. Demographics, clinical features, co-morbidities, laboratory and disease activity parameters collected from the database. The diagnosis of IBD was accepted with colonoscopy findings and pathology. Results: Overall, 469 PsA patients (70% females) with the mean age 47.7±12.4 years and [median (IQR)] disease duration 7 (3-11) years included in the study. Overall, 10/469 (5 male) PsA patients (2.1%) had IBD (7 (70%) with ulcerative colitis and 3 (30%) Crohn’s disease). Mean age of the patients was 53.3±10.0 years and mean disease duration was 9.0 ± 6.1 years. Six of ten patients were diagnosed with IBD before PsA and 4 of them were diagnosed with PsA first. Patients were followed-up for 3.7±2.8 years and bDMARD switch were made in 4 patients mostly due to primary inefficacy. bDMARD was discontinued in 2 patients (one for Crohn disease with fistula and one for drug induced SLE). According to DAPSA score 44% of the patients had low disease activity and 56% of the patients had moderate disease activity at last visit (9 patients were available). Sacroiliitis (70%) and severe radiographic hip (20%) involvement were common in PsA patients with IBD. Disease characteristics and demographic data are given in table 1. Table 1. Disease characteristics and demographic data of PsA patients with IBD Age (years) /sex Disease duration (years) IBD type Sacroiliitis Last visit treatments 61/M 16 Crohn’s disease (+) Azathioprine, GC 50/M 5 Ulcerative colitis (+), hip Adalimumab, GC 59/F 3 Ulcerative colitis (+) Certolizumab, methotrexate 40/F 10 Ulcerative colitis - Adalimumab, methotrexate 71/M 19 Ulcerative colitis - Infliximab 62/M 13 Crohn’s disease (+), hip Azathioprine, GC, sulphasalazine 50/F 1 Ulcerative colitis - Adalimumab, GC 59/M 12 Crohn’s disease (+) Secukinumab, GC 45/F 9 Ulcerative colitis (+) Adalimumab, methotrexate, GC 36/F 5 Ulcerative colitis (+) Infliximab, methotrexate, GC Conclusion: In our single center biological registry, relatively small portion of PsA patients had concomitant IBD, however, those cases may have severe axial involvement, particularly in hip involvement, and further studies needed for these subgroup. Physician should be aware those SpA subgroup, because treatment choices, particularly IL-17 inhibitors may have some cautions patients with PsA and IBD. Disclosure of Interests: Gözde Kübra Yardimci: None declared, Bayram Farisoğullari: None declared, Berkan Armagan: None declared, Emre Bilgin: None declared, Ertugrul Cagri Bolek: None declared, Emine Duran: None declared, Levent Kiliç: None declared, Omer Karadag: None declared, Ali Akdoğan: None declared, Şule Apraş Bilgen: None declared, Ali İhsan Ertenli: None declared, Sedat Kiraz: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB