Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis

Objective To evaluate the prevalence of symptoms and factors associated with irritable bowel syndrome (IBS) in axial spondyloarthritis (ax-SpA).Methods In a cross-sectional multicentric study, consecutive patients with ax-SpA treated with biologics in five rheumatology departments were asked for IBS...

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Main Authors: Adeline Ruyssen-Witrand, Thomas Barnetche, Cécile Gaujoux-Viala, Sylvain Mathieu, Anne Tournadre, Marie-Elise Truchetet, Cédric Lukas, Jessika Bernard, Charlotte Amory, Jerome Despres, Maxime Vandersmissen, Justine Landrin, Pascale Vergne-Salle
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003836.full
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author Adeline Ruyssen-Witrand
Thomas Barnetche
Cécile Gaujoux-Viala
Sylvain Mathieu
Anne Tournadre
Marie-Elise Truchetet
Cédric Lukas
Jessika Bernard
Charlotte Amory
Jerome Despres
Maxime Vandersmissen
Justine Landrin
Pascale Vergne-Salle
author_facet Adeline Ruyssen-Witrand
Thomas Barnetche
Cécile Gaujoux-Viala
Sylvain Mathieu
Anne Tournadre
Marie-Elise Truchetet
Cédric Lukas
Jessika Bernard
Charlotte Amory
Jerome Despres
Maxime Vandersmissen
Justine Landrin
Pascale Vergne-Salle
author_sort Adeline Ruyssen-Witrand
collection DOAJ
description Objective To evaluate the prevalence of symptoms and factors associated with irritable bowel syndrome (IBS) in axial spondyloarthritis (ax-SpA).Methods In a cross-sectional multicentric study, consecutive patients with ax-SpA treated with biologics in five rheumatology departments were asked for IBS Rome IV criteria. Demographic data, lifestyle behaviours and disease characteristics were recorded. Second, a systematic literature review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results Of the 500 patients with ax-SpA included, 124 reported IBS symptoms (25%). Female gender, unemployment, higher Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and worse Bath Ankylosing Spondylitis Functional Index scores, multiple lines of biologics, fibromyalgia, anxiety, depression and lower physical activity were associated with IBS symptoms. In multivariate model, the risk of IBS was associated with anxiety and physical inactivity. From the literature review, the prevalence of IBS in patients with SpA was 15.4% (8.8% to 23.3%). Meta-analysis of the five studies comparing the presence of IBS in patients with SpA (323/7292) and healthy controls (484/35587) showed a significant increase of IBS in patients with SpA (OR=1.59 (1.05 to 2.40)).Conclusion The prevalence of IBS symptoms was high in the ax-SpA population and should therefore be considered in the presence of gastrointestinal disorders. The presence of IBS symptoms was associated with anxiety and low physical activity in multivariate analysis. Patients with IBS symptoms tended to have more difficult to manage disease characterised by higher activity, worse functional score and multiple lines of treatment in univariate analysis.
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spelling doaj-art-c77e433730274ed89aed3411f92d80e02025-08-20T01:48:50ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003836Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysisAdeline Ruyssen-Witrand0Thomas Barnetche1Cécile Gaujoux-Viala2Sylvain Mathieu3Anne Tournadre4Marie-Elise Truchetet5Cédric Lukas6Jessika Bernard7Charlotte Amory8Jerome Despres9Maxime Vandersmissen10Justine Landrin11Pascale Vergne-Salle1211 Rheumatology, Service de Rhumatologie, C.H.U. Purpan, Toulouse, FranceRheumatology Department, FHU ACRONIM, University Hospital Centre Bordeaux, Bordeaux, Nouvelle-Aquitaine, FranceDepartment of Rheumatology, Nîmes University Hospital, Montpellier University, Nîmes, France10 INSERM, Neurodol, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France1 Department of Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand, France35 ImmunoConcEpT, UMR 5164, Université de Bordeaux, CNRS, Bordeaux, FranceUMR UA11 INSERM (IDESP), University of Montpellier, Montpellier, FranceRheumatology, Clermont-Ferrand University Hospital, Rheumatology Department, UNH-UMR 1019, INRAe and University Clermont Auvergne, Clermont-Ferrand, FranceRheumatology, University Hospital Lapeyronie, Montpellier, FranceRheumatology, Toulouse University Hospital, Rheumatology Centre, Centre d`Investigation Clinique de Toulouse CIC1436, Inserm, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS » University of Toulouse 3, Toulouse, FranceRheumatology, Limoges University Hospital, team CAPtuR, UMR Inserm 1308, University of Limoges, France, Limoges, FranceRheumatology, Bordeaux University Hospital FHU ACRONIM, Bordeaux, FranceUniversity Hospital Centre of Limoges, Limoges, FranceObjective To evaluate the prevalence of symptoms and factors associated with irritable bowel syndrome (IBS) in axial spondyloarthritis (ax-SpA).Methods In a cross-sectional multicentric study, consecutive patients with ax-SpA treated with biologics in five rheumatology departments were asked for IBS Rome IV criteria. Demographic data, lifestyle behaviours and disease characteristics were recorded. Second, a systematic literature review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results Of the 500 patients with ax-SpA included, 124 reported IBS symptoms (25%). Female gender, unemployment, higher Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and worse Bath Ankylosing Spondylitis Functional Index scores, multiple lines of biologics, fibromyalgia, anxiety, depression and lower physical activity were associated with IBS symptoms. In multivariate model, the risk of IBS was associated with anxiety and physical inactivity. From the literature review, the prevalence of IBS in patients with SpA was 15.4% (8.8% to 23.3%). Meta-analysis of the five studies comparing the presence of IBS in patients with SpA (323/7292) and healthy controls (484/35587) showed a significant increase of IBS in patients with SpA (OR=1.59 (1.05 to 2.40)).Conclusion The prevalence of IBS symptoms was high in the ax-SpA population and should therefore be considered in the presence of gastrointestinal disorders. The presence of IBS symptoms was associated with anxiety and low physical activity in multivariate analysis. Patients with IBS symptoms tended to have more difficult to manage disease characterised by higher activity, worse functional score and multiple lines of treatment in univariate analysis.https://rmdopen.bmj.com/content/10/1/e003836.full
spellingShingle Adeline Ruyssen-Witrand
Thomas Barnetche
Cécile Gaujoux-Viala
Sylvain Mathieu
Anne Tournadre
Marie-Elise Truchetet
Cédric Lukas
Jessika Bernard
Charlotte Amory
Jerome Despres
Maxime Vandersmissen
Justine Landrin
Pascale Vergne-Salle
Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
RMD Open
title Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
title_full Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
title_fullStr Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
title_full_unstemmed Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
title_short Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis
title_sort frequency of irritable bowel syndrome in spondyloarthritis a multicentric cross sectional study and meta analysis
url https://rmdopen.bmj.com/content/10/1/e003836.full
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