Pharmacological arsenal in arthropathies with enteropathic origin
Keywords:
Spondyloarthritis; inflammatory bowel disease; pharmacologic therapyAbstract
Introduction: More than half of the patients with Inflammatory Bowel Disease (IBD) present, at least, one extraintestinal manifestation, mainly articular, with interference in their quality of life. Furthermore, the pathogenic mechanisms that explain the link between intestinal and joint pathologies are not well defined yet. The aim of this work is to review the current pharmacotherapeutical arsenal against arthropathies associated with IBD.
Method: A bibliographic search of the literature was undertaken, the databases consulted were Medline through PubMed and Scopus from December 14 to 22. Only studies carried out in the last 15 years were selected. The keywords used were: Spondyloarthritis, “inflammatory bowel disease” and “pharmacologic therapy”. The European Crohn's and Colitis Organization (ECCO) and the European Medicines Agency (EMA) were also consulted.
Results: There are differences between the therapeutic approach to axial and peripheral spondyloarthritis. Pharmacological management has included mainly of aminosalicylates, corticosteroids, immunosuppressants, methotrexate and biological agents, among which infliximab stands out due to its dual action on intestinal and joint conditions. Better targeted therapies such as vedolizumab, ustekinumab, and selective inhibitors of JANUS-associated tyrosine kinases (JAK) have recently emerged in search of more personalized treatments.
Conclusion: The algorithms are very disparate among the consulted sources, which highlights the need for a comprehensive multidisciplinary management that would improve the quality of life of the patient. Reaching consensus on the optimal approach for each case is a challenge for both the gastroenterologist and the rheumatologist.
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