Incidence of spondyloarthropathy in patients with Crohn's disease: A population-based study

Raina Shivashankar, Edward Vincent Loftus, Jr, William J. Tremaine, Tim Bongartz, W. Scott Harmsen, Alan R. Zinsmeister, Eric Lawrence Matteson

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective. Spondyloarthritis (SpA) is an extraintestinal manifestation of inflammatory bowel disease with significant clinical effects, although the frequency is uncertain. We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort. Methods. The medical records of a population-based cohort of Olmsted County, Minnesota, residents diagnosed with CD between 1970 and 2004 were reviewed. Patients were followed longitudinally until migration, death, or December 31, 2010. We used the European Spondylarthropathy Study Group, Assessment of Spondyloarthritis international Society (ASAS) criteria and modified New York criteria to identify patients with SpA. The Kaplan-Meier method was used to estimate the cumulative incidence of SpA following diagnosis of CD. Results. The cohort included 311 patients with CD (49.8% females; median age 29.9 yrs, range 8-89). Thirty-two patients developed SpA based on ASAS criteria. The cumulative incidence of SpA after CD diagnosis was 6.7% (95% CI 2.5%-6.7%) at 10 years, 13.9% (95% CI 8.7%-18.8%) at 20 years, and 18.6% (95% CI 11.0%-25.5%) at 30 years. The 10-year cumulative incidence of ankylosing spondylitis was 0, while both the 20-year and 30-year cumulative incidences were 0.5% (95% CI 0-1.6%). Conclusion. We have for the first time defined the actual cumulative incidence of SpA in CD using complete medical record information in a population-based cohort. The cumulative incidence of all forms of SpA increased to approximately 19% by 30 years from diagnosis of CD. Our results emphasize the importance of maintaining a high level of suspicion for SpA when following patients with CD. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)2148-2152
Number of pages5
JournalJournal of Rheumatology
Volume39
Issue number11
DOIs
StatePublished - Nov 2012

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Spondylarthropathies
Crohn Disease
Incidence
Population
Medical Records
Ankylosing Spondylitis
Rheumatology
Inflammatory Bowel Diseases

Keywords

  • Ankylosing spondylitis
  • Crohn's disease
  • Epidemiology
  • Spondyloarthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Incidence of spondyloarthropathy in patients with Crohn's disease : A population-based study. / Shivashankar, Raina; Loftus, Jr, Edward Vincent; Tremaine, William J.; Bongartz, Tim; Harmsen, W. Scott; Zinsmeister, Alan R.; Matteson, Eric Lawrence.

In: Journal of Rheumatology, Vol. 39, No. 11, 11.2012, p. 2148-2152.

Research output: Contribution to journalArticle

Shivashankar, Raina ; Loftus, Jr, Edward Vincent ; Tremaine, William J. ; Bongartz, Tim ; Harmsen, W. Scott ; Zinsmeister, Alan R. ; Matteson, Eric Lawrence. / Incidence of spondyloarthropathy in patients with Crohn's disease : A population-based study. In: Journal of Rheumatology. 2012 ; Vol. 39, No. 11. pp. 2148-2152.
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abstract = "Objective. Spondyloarthritis (SpA) is an extraintestinal manifestation of inflammatory bowel disease with significant clinical effects, although the frequency is uncertain. We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort. Methods. The medical records of a population-based cohort of Olmsted County, Minnesota, residents diagnosed with CD between 1970 and 2004 were reviewed. Patients were followed longitudinally until migration, death, or December 31, 2010. We used the European Spondylarthropathy Study Group, Assessment of Spondyloarthritis international Society (ASAS) criteria and modified New York criteria to identify patients with SpA. The Kaplan-Meier method was used to estimate the cumulative incidence of SpA following diagnosis of CD. Results. The cohort included 311 patients with CD (49.8{\%} females; median age 29.9 yrs, range 8-89). Thirty-two patients developed SpA based on ASAS criteria. The cumulative incidence of SpA after CD diagnosis was 6.7{\%} (95{\%} CI 2.5{\%}-6.7{\%}) at 10 years, 13.9{\%} (95{\%} CI 8.7{\%}-18.8{\%}) at 20 years, and 18.6{\%} (95{\%} CI 11.0{\%}-25.5{\%}) at 30 years. The 10-year cumulative incidence of ankylosing spondylitis was 0, while both the 20-year and 30-year cumulative incidences were 0.5{\%} (95{\%} CI 0-1.6{\%}). Conclusion. We have for the first time defined the actual cumulative incidence of SpA in CD using complete medical record information in a population-based cohort. The cumulative incidence of all forms of SpA increased to approximately 19{\%} by 30 years from diagnosis of CD. Our results emphasize the importance of maintaining a high level of suspicion for SpA when following patients with CD. The Journal of Rheumatology",
keywords = "Ankylosing spondylitis, Crohn's disease, Epidemiology, Spondyloarthritis",
author = "Raina Shivashankar and {Loftus, Jr}, {Edward Vincent} and Tremaine, {William J.} and Tim Bongartz and Harmsen, {W. Scott} and Zinsmeister, {Alan R.} and Matteson, {Eric Lawrence}",
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T1 - Incidence of spondyloarthropathy in patients with Crohn's disease

T2 - A population-based study

AU - Shivashankar, Raina

AU - Loftus, Jr, Edward Vincent

AU - Tremaine, William J.

AU - Bongartz, Tim

AU - Harmsen, W. Scott

AU - Zinsmeister, Alan R.

AU - Matteson, Eric Lawrence

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N2 - Objective. Spondyloarthritis (SpA) is an extraintestinal manifestation of inflammatory bowel disease with significant clinical effects, although the frequency is uncertain. We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort. Methods. The medical records of a population-based cohort of Olmsted County, Minnesota, residents diagnosed with CD between 1970 and 2004 were reviewed. Patients were followed longitudinally until migration, death, or December 31, 2010. We used the European Spondylarthropathy Study Group, Assessment of Spondyloarthritis international Society (ASAS) criteria and modified New York criteria to identify patients with SpA. The Kaplan-Meier method was used to estimate the cumulative incidence of SpA following diagnosis of CD. Results. The cohort included 311 patients with CD (49.8% females; median age 29.9 yrs, range 8-89). Thirty-two patients developed SpA based on ASAS criteria. The cumulative incidence of SpA after CD diagnosis was 6.7% (95% CI 2.5%-6.7%) at 10 years, 13.9% (95% CI 8.7%-18.8%) at 20 years, and 18.6% (95% CI 11.0%-25.5%) at 30 years. The 10-year cumulative incidence of ankylosing spondylitis was 0, while both the 20-year and 30-year cumulative incidences were 0.5% (95% CI 0-1.6%). Conclusion. We have for the first time defined the actual cumulative incidence of SpA in CD using complete medical record information in a population-based cohort. The cumulative incidence of all forms of SpA increased to approximately 19% by 30 years from diagnosis of CD. Our results emphasize the importance of maintaining a high level of suspicion for SpA when following patients with CD. The Journal of Rheumatology

AB - Objective. Spondyloarthritis (SpA) is an extraintestinal manifestation of inflammatory bowel disease with significant clinical effects, although the frequency is uncertain. We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort. Methods. The medical records of a population-based cohort of Olmsted County, Minnesota, residents diagnosed with CD between 1970 and 2004 were reviewed. Patients were followed longitudinally until migration, death, or December 31, 2010. We used the European Spondylarthropathy Study Group, Assessment of Spondyloarthritis international Society (ASAS) criteria and modified New York criteria to identify patients with SpA. The Kaplan-Meier method was used to estimate the cumulative incidence of SpA following diagnosis of CD. Results. The cohort included 311 patients with CD (49.8% females; median age 29.9 yrs, range 8-89). Thirty-two patients developed SpA based on ASAS criteria. The cumulative incidence of SpA after CD diagnosis was 6.7% (95% CI 2.5%-6.7%) at 10 years, 13.9% (95% CI 8.7%-18.8%) at 20 years, and 18.6% (95% CI 11.0%-25.5%) at 30 years. The 10-year cumulative incidence of ankylosing spondylitis was 0, while both the 20-year and 30-year cumulative incidences were 0.5% (95% CI 0-1.6%). Conclusion. We have for the first time defined the actual cumulative incidence of SpA in CD using complete medical record information in a population-based cohort. The cumulative incidence of all forms of SpA increased to approximately 19% by 30 years from diagnosis of CD. Our results emphasize the importance of maintaining a high level of suspicion for SpA when following patients with CD. The Journal of Rheumatology

KW - Ankylosing spondylitis

KW - Crohn's disease

KW - Epidemiology

KW - Spondyloarthritis

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