P0771 - IB-DART: A Combined Gastroenterology and Rheumatology Clinic Assessing Spondyloarthritis in Inflammatory Bowel Disease Patients—A 2-Year Experience

Ishaan Dharia, MD, Bahar Moghaddam, MD, Abhik Bhattacharya, MD
Icahn School of Medicine at Mount Sinai, New York, NY

Introduction: Extra-intestinal manifestations of Inflammatory Bowel Disease (IBD) have significant morbidity. One of the more common manifestations is spondyloarthritis (SpA), which has a reported prevalence of over 25%. A delay in SpA diagnosis in IBD patients can lead to radiographic progression of disease and disability. The aim of this study is to provide insight into the outcomes of IBD patients with SpA and evaluate the role of a joint gastroenterology-rheumatology clinic in decreasing diagnostic delay.

Methods: We conducted a retrospective chart review of adult patients with IBD and joint pain who were evaluated in a combined GI and Rheumatology Clinic (IB-DART) at a large tertiary-care, high-volume IBD center. A multidisciplinary approach was taken for both diagnosis and treatment. Descriptive statistics were used to analyze IBD patients by SpA type and evaluate treatment changes made after assessment in the IB-DART clinic.

Results: Sixty-two patients (61.3% female) were included in the study, with an average age of 42.7 ± 13.7 years (Table 1). Of these, 72.6% had Crohn’s Disease. Fifty-one (82.3%) patients were referred to the multidisciplinary clinic with concern for underlying SpA, and 11 (17.7%) for worsening SpA. After combined gastroenterology and rheumatology assessment, 19 patients were newly diagnosed with SpA, 14 with presumed SpA were found to have an alternate cause of musculoskeletal pain (i.e., osteoarthritis, fibromyalgia), and 1 had their IBD diagnosis changed to IBS.

Ultimately, 25 patients had their treatment regimen modified after being seen in the IB-DART clinic; treatment changes are depicted in Figure 1. Notably, while most patients with a new diagnosis of both axial and peripheral SpA were more likely to be started on an anti-TNF or JAK-inhibitor (42.9% and 28.6%, respectively), those with only peripheral SpA were more likely to be treated with an IL12/23 inhibitor or non-biologic DMARDs (63.6%).

Finally, the average time from the first IB-DART visit to SpA diagnosis was 129 days. The average time from initial referral to the IB-DART clinic to the first appointment was 38.6 days.

Discussion: Managing SpA in the context of IBD can be challenging. A multidisciplinary approach to these patients can help ensure correct and timely diagnosis, thereby more quickly improving morbidity. This study helps illuminate characteristics of patients with IBD and SpA and demonstrates the value of a multidisciplinary approach to these patients.




Disclosures:


Ishaan Dharia, MD, Bahar Moghaddam, MD, Abhik Bhattacharya, MD. P0771 - IB-DART: A Combined Gastroenterology and Rheumatology Clinic Assessing Spondyloarthritis in Inflammatory Bowel Disease Patients—A 2-Year Experience, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.