PO:01:015 | Evaluation of the impact of concomitant psoriasis on the clinical and therapeutic pattern of a monocentric cohort of patients affected by spondyloarthritis associated with inflammatory bowel diseases

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; ²SC Reumatologia, AOU Cagliari; ³SC Gastroenterologia, AOU Cagliari, Italy

Background. To evaluate the influence of concomitant psoriasis (PsO) on the clinical and therapeutic pattern of a monocentric cohort of patients affected by Spondyloarthritis (SpA) associated with inflammatory bowel diseases (IBD). Materials and Methods. This study represents a preliminary phase of an ancillary analysis of the DIAMANTE project (Early diagnosis of spondyloarthritis in a cohort of patients affected by inflammatory bowel disease), developed with the general objective of determining the prevalence, predictors, and outcomes of SpA in a cohort of IBD patients, within the context of a close and structured collaboration between gastroenterologists and rheumatologists. Within the DIAMANTE cohort, two subgroups of patients were identified for the study: patients with enteropathic SpA and a concomitant personal diagnosis of PsO (Group 1: IBD+SpA+PsO), and patients with a diagnosis of SpA only (Group 0: IBD+SpA). For both groups, the following demographic, clinical, and therapeutic data were recorded and compared: sex, association with IBD pattern, peripheral joint involvement, axial involvement, history of dactylitis, need for biologic therapy, and multi-resistance to “targeted” drugs (defined as discontinuation due to inefficacy of at least two biologic drugs or small molecules). A p-value <0.05 was considered statistically significant using Fisher’s exact test and the Chi-square test. Results. Data from 665 consecutive patients with IBD recruited between November 2023 and April 2025 were analyzed. Within this cohort, 95 (14%) had a concomitant diagnosis of SpA; among these, 21 (22%) also had a diagnosis of PsO (Group IBD+SpA+PsO), while 74 (78%) had only SpA associated with IBD (Group IBD+SpA). Comparative analysis between the two groups showed notable—though only trending toward 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 multi-resistance to biologic treatment was observed in patients with concomitant PsO compared to those with IBD and SpA only (29% vs 11%, p=0.04). No significant differences were observed regarding the distribution of different IBD types (ulcerative colitis, Crohn’s disease, indeterminate forms) between the two study groups. Conclusions. In patients with SpA associated with IBD, a frequent concomitant association with PsO—another extra-articular domain typical of the spondyloenthesitis spectrum—was demonstrated. The results of this exploratory analysis suggest the usefulness of further investigating, in larger prospective cohorts, the impact that such a dual combination of extra-articular manifestations may have on disease characteristics and, in particular, on therapeutic management.