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Carubbi F, Alunno A, Viscido A, Baraliakos X, Mariani FM, Di Ruscio E, Altieri P, Ferri C. SpA plus IBD or IBD plus SpA: Does commutative property apply? Autoimmun Rev 2023; 22:103443. [PMID: 37678619 DOI: 10.1016/j.autrev.2023.103443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/09/2023]
Abstract
The term spondyloarthritis (SpA) encompasses a group of interrelated disorders characterised by the involvement of the musculoskeletal system as well as extra-articular manifestations like acute anterior uveitis, psoriasis and inflammatory bowel diseases (IBD). Likewise, IBD may present with various extra-intestinal manifestations among which those involving the musculoskeletal system, namely peripheral and axial SpA are the most common. The identification of patients with both SpA and IBD is of paramount importance in clinical practice since the coexistence of these two entities has been associated with great disability and decreased quality of life. In order to achieve an early diagnosis of IBD-SpA it is instrumental that rheumatologists seek for gastrointestinal symptoms in SpA patients and likewise that gastroenterologists seek for inflammatory musculoskeletal symptoms in patients with IBD. This narrative review aims at critically appraising the available evidence about SpA occurring in IBD patients versus IBD occurring in patients with SpA and at highlighting similarities and differences between the two scenarios.
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Affiliation(s)
- Francesco Carubbi
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy.
| | - Alessia Alunno
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Angelo Viscido
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | | | - Francesco Maria Mariani
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Evy Di Ruscio
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Piera Altieri
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Claudio Ferri
- University of L'Aquila, Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
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Cozzi G, Scagnellato L, Lorenzin M, Savarino E, Zingone F, Ometto F, Favero M, Doria A, Vavricka SR, Ramonda R. Spondyloarthritis with inflammatory bowel disease: the latest on biologic and targeted therapies. Nat Rev Rheumatol 2023:10.1038/s41584-023-00984-8. [PMID: 37386288 DOI: 10.1038/s41584-023-00984-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 07/01/2023]
Abstract
Spondyloarthritis (SpA) encompasses a heterogeneous group of chronic inflammatory diseases that can affect both axial and peripheral joints, tendons and entheses. Among the extra-articular manifestations, inflammatory bowel disease (IBD) is associated with considerable morbidity and effects on quality of life. In everyday clinical practice, treatment of these conditions requires a close collaboration between gastroenterologists and rheumatologists to enable early detection of joint and intestinal manifestations during follow-up and to choose the most effective therapeutic regimen, implementing precision medicine for each patient's subtype of SpA and IBD. The biggest issue in this field is the dearth of drugs that are approved for both diseases, as only TNF inhibitors are currently approved for the treatment of full-spectrum SpA-IBD. Janus tyrosine kinase inhibitors are among the most promising drugs for the treatment of peripheral and axial SpA, as well as for intestinal manifestations. Other therapies such as inhibitors of IL-23 and IL-17, phosphodiesterase 4 inhibitor, α4β7 integrin blockers and faecal microbiota transplantation seem to only be able to control some disease domains, or require further studies. Given the growing interest in the development of novel drugs to treat both conditions, it is important to understand the current state of the art and the unmet needs in the management of SpA-IBD.
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Affiliation(s)
- Giacomo Cozzi
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Laura Scagnellato
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Mariagrazia Lorenzin
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padova, Italy
| | - Fabiana Zingone
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padova, Italy
| | - Francesca Ometto
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Stephan R Vavricka
- Department of Gastroenterology and Hepatology, University Hospital Zürich and Center for Gastroenterology and Hepatology, Zürich, Switzerland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy.
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3
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Wang CR, Tsai HW. Seronegative spondyloarthropathy-associated inflammatory bowel disease. World J Gastroenterol 2023; 29:450-468. [PMID: 36688014 PMCID: PMC9850936 DOI: 10.3748/wjg.v29.i3.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/18/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Seronegative spondyloarthropathy (SpA) usually starts in the third decade of life with negative rheumatoid factor, human leukocyte antigen-B27 genetic marker and clinical features of spinal and peripheral arthritis, dactylitis, enthesitis and extra-articular manifestations (EAMs). Cases can be classified as ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, or juvenile-onset spondyloarthritis. Joint and gut inflammation is intricately linked in SpA and inflammatory bowel disease (IBD), with shared genetic and immunopathogenic mechanisms. IBD is a common EAM in SpA patients, while extraintestinal manifestations in IBD patients mostly affect the joints. Although individual protocols are available for the management of each disease, the standard therapeutic guidelines of SpA-associated IBD patients remain to be established. Nonsteroidal anti-inflammatory drugs are recommended as initial therapy of peripheral and axial SpA, whereas their use is controversial in IBD due to associated disease flares. Conventional disease-modifying anti-rheumatic drugs are beneficial for peripheral arthritis but ineffective for axial SpA or IBD therapy. Anti-tumor necrosis factor monoclonal antibodies are effective medications with indicated use in SpA and IBD, and a drug of choice for treating SpA-associated IBD. Janus kinase inhibitors, approved for treating SpA and ulcerative colitis, are promising therapeutics in SpA coexistent with ulcerative colitis. A tight collaboration between gastroenterologists and rheumatologists with mutual referral from early accurate diagnosis to appropriately prompt therapy is required in this complex clinical scenario.
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Affiliation(s)
- Chrong-Reen Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan
| | - Hung-Wen Tsai
- Department of Pathology, National Cheng Kung University Hospital, Tainan 70403, Taiwan
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4
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Silva-Díaz M, Blanco FJ, Quevedo Vila V, Seoane-Mato D, Pérez-Ruiz F, Juan-Mas A, Pego-Reigosa JM, Narváez J, Quilis N, Cortés R, Romero Pérez A, Fábregas Canales D, Font Gayá T, Bordoy Ferrer C, Prado-Galbarro FJ, Sánchez-Piedra C, Díaz-González F, Bustabad-Reyes S. Prevalence of symptomatic axial osteoarthritis phenotypes in Spain and associated socio-demographic, anthropometric, and lifestyle variables. Rheumatol Int 2022; 42:1085-1096. [PMID: 34755205 PMCID: PMC9124650 DOI: 10.1007/s00296-021-05038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Axial osteoarthritis (OA) is a common cause of back and neck pain, however, few studies have examined its prevalence. The aim was to estimate the prevalence and the characteristics of symptomatic axial OA in Spain. METHODS EPISER2016 is a cross-sectional multicenter population-based study of people aged 40 years or older. Subjects were randomly selected using multistage stratified cluster sampling. Participants were contacted by telephone to complete rheumatic disease screening questionnaires. Two phenotypes were analyzed, patients with Non-exclusive axial OA (NEA-OA) and Exclusive axial OA (EA-OA). To calculate the prevalence and its 95% confidence interval (CI), the sample design was considered and weighting was calculated according to age, sex and geographic origin. RESULTS Prevalence of NEA-OA by clinical or clinical-radiographic criteria was 19.17% (95% CI: 17.82-20.59). The frequency of NEA-OA increased with age (being 3.6 times more likely in patients aged 80 s or more than in those between 40 and 49 years) and body mass index. It was significantly more frequent in women, as well as in the center of Spain. It was less frequent in those with a higher level of education. Lumbar OA was more frequent than cervical OA. This difference grew with increasing age and was not associated with gender. It was also greater in overweight and obese subjects. CONCLUSIONS This is the first study on the prevalence of axial OA phenotypes in Europe describing the associated socio-demographic, anthropometric, and lifestyle variables.
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Affiliation(s)
- Maite Silva-Díaz
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
| | - Francisco J Blanco
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain.
- Universidade da Coruña (UDC), Grupo de Investigación de Reumatología y Salud (GIR-S). Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia,, Campus de Oza, A Coruña, España.
| | - Víctor Quevedo Vila
- Rheumatology Unit, Hospital Comarcal Monforte de Lemos, Monforte de Lemos, Lugo, España
| | | | - Fernando Pérez-Ruiz
- Rheumatology Department, Hospital Universitario Cruces, Baracaldo, Vizcaya, España
| | - Antonio Juan-Mas
- Rheumatology Department, Hospital Son LLàtzer, Palma de Mallorca, Baleares, España
| | - José M Pego-Reigosa
- Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Grupo IRIDIS, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Pontevedra, España
| | - Javier Narváez
- Rheumatology Department, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Neus Quilis
- Rheumatology Department, Hospital General Universitario de Elda, Elda, Alicante, España
| | - Raúl Cortés
- Rheumatology Department, Hospital General de Ontinyent, Ontinyent, Valencia, España
| | | | | | - Teresa Font Gayá
- Rheumatology Department, Hospital Comarcal de Inca, Inca, Baleares, España
| | | | | | | | - Federico Díaz-González
- Department of Internal Medicine, Dermatology and Psyquiatry, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, España
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Sagrario Bustabad-Reyes
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
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Gomollón F, Seoane-Mato D, Montoro MA, Juanola X, Trujillo-Martin E, Carrillo-Palau M, Matallana V, García-Magallón B, Ber Y, Ramos L, Perez-Pampin E, Ferreiro-Iglesias R, Rodríguez-Alonso L, Marco-Pascual C, Sanz Sanz J. Validation of screening criteria for spondyloarthritis in patients with inflammatory bowel disease in routine clinical practice. Dig Liver Dis 2022; 54:755-762. [PMID: 35039222 DOI: 10.1016/j.dld.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Spondyloarthritis (SpA) is one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD). Diagnostic delay must be avoided. AIMS We assessed the validity of SpA screening criteria (any of the following characteristics: chronic low back pain with onset before 45 years of age; inflammatory lower back pain or alternating buttock pain; arthritis; heel enthesitis; dacylitis; HLA-B27 positivity; sacroiliitis on imaging). METHODS This was a multicenter cross-sectional observational study in IBD patients aged ≥18 years. After evaluating the SpA screening criteria, the gastroenterologists referred the participants to the rheumatologists, who determined whether the patient fulfilled the screening criteria and carried out the necessary tests for SpA diagnosis. RESULTS 35 (11.7%) out of 300 patients were diagnosed with SpA. The combination with the best balance between sensitivity and specificity (91.4% and 72.1%, respectively, when applied by the rheumatologists; 80% and 78.9%, when applied by the gastroenterologists) for SpA screening, was fulfillment of any of the following: chronic low back pain with onset before age 45 years, inflammatory low back pain or alternating buttock pain, arthritis, or dactylitis. CONCLUSION This is one of the first studies to validate SpA screening criteria in IBD patients in routine clinical practice.
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Affiliation(s)
- Fernando Gomollón
- Medical School, University of Zaragoza, IIS Aragón, CIBEREHD, Zaragoza, Spain.
| | | | - Miguel A Montoro
- Unit of Gastroenterology, Hepatology and Nutrition, Hospital General San Jorge, Huesca, Spain
| | - Xavier Juanola
- Department of Rheumatology, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Elisa Trujillo-Martin
- Department of Rheumatology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Marta Carrillo-Palau
- Department of Gastroenterology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Virginia Matallana
- Department of Gastroenterology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Yolanda Ber
- Unit of Gastroenterology, Hepatology and Nutrition, Hospital General San Jorge, Huesca, Spain
| | - Laura Ramos
- Department of Gastroenterology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Eva Perez-Pampin
- Department of Rheumatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Rocío Ferreiro-Iglesias
- Department of Gastroenterology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Lorena Rodríguez-Alonso
- Department of Gastroenterology and Hepatology, Hospital Universitari de Bellvitge- IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carla Marco-Pascual
- Department of Rheumatology, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jesús Sanz Sanz
- Department of Rheumatology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
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Ribaldone DG, Vernero M, Parisi S, Ditto MC, Pellicano R, Morino M, Saracco GM, Fusaro E, Astegiano M. Risk factors of suspected spondyloarthritis among inflammatory bowel disease patients. Scand J Gastroenterol 2019; 54:1233-1236. [PMID: 31549896 DOI: 10.1080/00365521.2019.1668052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Occurring in approximately 20-30% of patients, spondyloarthritis is the most common extraintestinal manifestation in inflammatory bowel disease (IBD).Aims: To look for risk factors of spondyloarthritis among inflammatory bowel disease patients.Methods: We modified the STRIPP questionnaire created for psoriatic patients and we created a rapid questionnaire for rheumatologic investigation in IBD patients (STRII). We submitted the questionnaire to all consecutive patients with a known spondyloarthritis in our centre and to patients with a negative rheumatological diagnosis to find the cut-off value. Finally, we prospectively submitted the STRII questionnaire to all consecutive IBD patients in our centre.Results: A cut-off ≥3 correlated with spondyloarthritis with an AUC = 0.91. The STRII questionnaire was submitted to 1147 IBD patients. Two hundred and forty-four out of 1147 (21.3%) collected a STRII score of ≥3. Female sex (p < .0001) and Crohn's disease (p = .023) were risk factors. Patients with a history of at least 1 immunosuppressant or biologic drug (p = .002 and p < .0001, respectively) had a higher rate of positivity to STRII questionnaire.Conclusion: Among IBD patients, females, Crohn's disease, those with a history of at least 1 immunosuppressive or biological therapy are at increased risk of spondyloarthritis.
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Affiliation(s)
| | - Marta Vernero
- First Department of Internal Medicine, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Simone Parisi
- S.C. Reumatologia, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Maria Chiara Ditto
- S.C. Reumatologia, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | | | - Mario Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Enrico Fusaro
- S.C. Reumatologia, Città Della Salute e Della Scienza di Torino, Turin, Italy
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Navarro-Compán V, Otón T, Loza E, Almodóvar R, Ariza-Ariza R, Bautista-Molano W, Burgos-Vargas R, Collantes-Estévez E, de Miguel E, González-Fernández C, Gratacós J, Ibáñez S, Juanola X, Maldonado-Cocco J, Moltó A, Mulero J, Pacheco-Tena C, Ramos-Remus C, Sanz-Sanz J, Valle-Oñate R, Zarco P, Marzo-Ortega H. Assessment of SpondyloArthritis International Society (ASAS) Consensus on Spanish Nomenclature for Spondyloarthritis. ACTA ACUST UNITED AC 2018; 16:333-338. [PMID: 30193774 DOI: 10.1016/j.reuma.2018.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To develop a consensus to standardize the use of Spanish terms, abbreviations and acronyms in the field of spondyloarthritis (SpA). METHODS An international task force comprising all native Spanish-speaking Assessment of SpondyloArthritis International Society (ASAS) members, the executive committee of Grupo para el estudio de la Espondiloartritis de la Sociedad Española de Reumatología (GRESSER), two methodologists, two linguists from the Real Academia Nacional de Medicina de España (RANM) and two patients from the Spanish Coordinator of Spondylitis Associations (CEADE) was established. A literature review was performed to identify the conflicting terms/abbreviations/acronyms in SpA. This review examined written sources in Spanish including manuscripts, ICF and ICD, guidelines, recommendations and consensuses. This was followed by a nominal group meeting and a three-round Delphi. The recommendations from the RANM based on the Panhispanic dictionary were followed throughout the process. RESULTS Consensus was reached for 46 terms, abbreviations or acronyms related to the field of SpA. A Spanish translation was accepted for 6 terms and 6 abbreviations to name or classify the disease, and for 6 terms and 4 abbreviations related to SpA. It was agreed not to translate 15 acronyms into Spanish. However, when mentioning them, it was recommended to follow this structure: type of acronym in Spanish and acronym and expanded form in English. With regard to 7 terms or abbreviations attached to acronyms, it was agreed to translate only the expanded form and a translation was also selected for each of them. CONCLUSIONS Through this standardization, it is expected to establish a common use of the Spanish nomenclature for SpA. The implementation of this consensus across the community will be of substantial benefit, avoiding misunderstandings and time-consuming processes.
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Affiliation(s)
| | - Teresa Otón
- Instituto de Salud Musculoesquelética, Madrid, España
| | | | | | | | | | | | | | | | | | - Jordi Gratacós
- Hospital Universitario Parc Taulí de Sabadell, I3PT, Universitat Autònoma de Barcelona (UAB), Barcelona, España
| | - Sebastián Ibáñez
- Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago de Chile, Chile
| | - Xavier Juanola
- Hospital Universitario de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, España
| | | | - Anna Moltó
- Hôpital Cochin Hospital, Assistance Publique Hôpitaux de Paris-INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, París, Francia
| | - Juan Mulero
- Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | | | - Cesar Ramos-Remus
- Unidad de Investigación en Enfermedades Cronicodegenerativas, Ciudad de México, México
| | - Jesús Sanz-Sanz
- Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | | | - Pedro Zarco
- Hospital Universitario Fundación Alcorcón, Madrid, España
| | - Helena Marzo-Ortega
- NIHR Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, Reino Unido
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Felice C, Pugliese D, Papparella LG, Pizzolante F, Onori E, Gasbarrini A, Rapaccini GL, Guidi L, Armuzzi A. Clinical management of rheumatologic conditions co-occurring with inflammatory bowel diseases. Expert Rev Clin Immunol 2018; 14:751-759. [DOI: 10.1080/1744666x.2018.1513329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carla Felice
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Pugliese
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Giovanni Papparella
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Pizzolante
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenia Onori
- Dipartimento di Medicina Interna, Università degli studi dell’Aquila, L’Aquila, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine, Gastroenterology Division, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Lodovico Rapaccini
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luisa Guidi
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Armuzzi
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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