PO:01:015 | Assessment of the impact of the co-occurrence of psoriasis on the clinical and therapeutic pattern of a single-centre cohort of patients with spondyloarthritis associated with chronic inflammatory bowel disease

Andrea Pace¹, Marcella Falconi¹, Alberto Floris^1|2, Leonardo Sichi¹, Francesca Onnis³, Lorenzo Meli³, Raffaela Piras³, Nicola Lutzu³, Federica Olla³, Agnese Favale³, Sara Onali³, Massimo Claudio Fantini³, Matteo Piga^1|2, Alberto Cauli^1|2. | ¹SC Reumatologia, Dipartimento di Scienze Mediche e Salute Pubblica, Università di Cagliari, Cagliari, Italy; ²SC Reumatologia, AOU Cagliari, Cagliari, Italy; ³SC Gastroenterologia, AOU Cagliari, Cagliari, Italy.

Background. To assess the influence of the co-presence of psoriasis (PsO) on the clinical and therapeutic pattern of a single-centre cohort of patients with spondyloarthritis (SpA) associated with chronic inflammatory bowel disease (IBD).

Methods. This study represents a preliminary phase of an ancillary analysis of the DIAMANTE project (Early diagnosis of spondyloarthritis in a cohort of patients with chronic inflammatory bowel disease), developed with the overall objective of determining the prevalence, predictors and outcomes of SpA in a cohort of subjects with IBD, in the context of close and structured collaboration between gastroenterologists and rheumatologists. Within the DIAMANTE cohort, two subgroups of patients were identified for the study: patients with SpA and a concomitant personal diagnosis of PsO (Group 1: IBD+SpA+PsO) and patients with a diagnosis of SpA alone (Group 0: IBD+SpA). For both groups, the following demographic, clinical and therapeutic data were recorded and compared: gender, association between IBD patterns, peripheral joint involvement, axial involvement, history of dactylitis, need for biological therapy, multi-resistance to targeted drugs (discontinuation due to ineffectiveness of at least two small molecule biological drugs). A significance threshold of p<0.05 was used with Fisher's and X² tests.

Results. Data from 665 consecutive patients with IBD recruited from November 2023 to April 2025 were analysed. Within this cohort, 95 (14%) had a concomitant diagnosis of SpA; among these, 21 (22%) also had a diagnosis of PsO (IBD+SpA+PsO group), while 74 (78%) had only SpA associated with IBD (IBD+SpA group). Comparative analysis of the two groups revealed significant, albeit only trending towards statistical significance, differences in terms of female prevalence (71% vs 54%, p=0.15), frequency of peripheral involvement (62% vs 49%, p=0.28) and use of biologic drugs (91% vs 77%; p=0.17). Most notably, a significantly higher frequency of multidrug resistance to biological drug treatment was observed in patients with concomitant PsA compared to patients with IBD and SpA alone (29% vs 11% p=0.04). No significant differences were observed in terms of destruction of the different IBD conditions (ulcerative colitis, Crohn's disease, undifferentiated forms) between the two study groups.

Conclusions. In patients with SpA associated with IBD, the simultaneous association with PsO, another extra-articular domain typical of the spectrum of spondyloarthropathies, was also frequently demonstrated. The results of this exploratory analysis suggest that it would be useful to investigate, in larger prospective case series, the impact that this dual combination of extra-articular manifestations may have on disease characteristics and, in particular, on treatment management.