Association of diverticulitis with prolonged spondyloarthritis: an analysis of the ASAS-COMOSPA international cohort

Derakhshan, M. H., Goodson, N. J., Packham, J., Sengupta, R., Molto, A., Marzo-Ortega, H., Siebert, S. and BRITSpA and the ASAS-COMOSPA Investigators, (2019) Association of diverticulitis with prolonged spondyloarthritis: an analysis of the ASAS-COMOSPA international cohort. Journal of Clinical Medicine, 8(3), 281. (doi: 10.3390/jcm8030281) (PMID:30813544)

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Abstract

This study examined the relationship between spondyloarthritis (SpA) duration and gastrointestinal comorbidities other than inflammatory bowel disease (IBD). We evaluated the association between SpA duration and upper gastrointestinal ulcers, hepatitis B (HBV), hepatitis C (HCV) and diverticulitis using data from a large international cross-sectional study. Binary regression models were created, adjusted for age, sex, body mass index (BMI), smoking, alcohol, non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), biologics, steroids, IBD history and country. Subgroup analysis was performed by disease phenotype. The data of 3923 participants were analysed. The prevalence of gastrointestinal conditions were 10.7% upper gastrointestinal ulcers; 4.7% viral hepatitis and 1.5% diverticulitis. While SpA duration was not associated with upper gastrointestinal ulcers, HBV or HCV, longer SpA duration was significantly associated with diverticulitis (odds ratios (OR) = 1.18, 95% confidence interval (CI): 1.03–1.34), reflecting an 18% increase for every five years of SpA duration. Other significant associations with diverticulitis were age and high alcohol intake but not medication history. In subgroup analyses, the association was strongest with those with axial SpA. The reasons for this association of increased diverticulitis with disease duration in SpA, especially those with axial disease, are unclear but may reflect shared underlying gut inflammation. Diverticulitis should be considered, in addition to IBD, when SpA patients present with lower gastrointestinal symptoms.

Item Type:Articles
Additional Information:The ASAS-COMOSPA study was performed with financial support from Abbvie, Pfizer and UCB, who provided an unrestricted grant to the Assessment of SpondyloArthritis international Society (ASAS) to fund the study. Mohammad H. Derakhshan’s work is supported by the British Society of Spondyloarthritis (BRITSpA).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Derakhshan, Professor Mohammad and Siebert, Professor Stefan
Creator Roles:
Siebert, S.Data curation, Conceptualization, Formal analysis, Writing – review and editing
Derakhshan, M. H.Conceptualization, Formal analysis, Writing – original draft, Writing – review and editing
Authors: Derakhshan, M. H., Goodson, N. J., Packham, J., Sengupta, R., Molto, A., Marzo-Ortega, H., Siebert, S., and BRITSpA and the ASAS-COMOSPA Investigators,
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Research Centre:College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
Journal Name:Journal of Clinical Medicine
Publisher:MDPI
ISSN:2077-0383
ISSN (Online):2077-0383
Published Online:26 February 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Journal of Clinical Medicine 8(3): 281
Publisher Policy:Reproduced under a Creative Commons License

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