Seronegative spondyloarthropathy-associated inflammatory bowel disease

Table 5 Classification of inflammatory bowel disease-associated peripheral arthritis

Category	Type 1 pauciarticular	Type 2 polyarticular
Prevalence	4% to 5% in IBD, higher in CD than UC	3% in IBD, higher in CD than UC
Joint manifestation
Involved numbers	< 5	≥ 5
Articular distribution	Large joint, asymmetric	Mainly small joint
Involved area with the decreasing frequencies	Knee, ankle, wrist, elbow, MCP, hip, shoulder, MTP, PIP	MCP, knee, PIP, wrist, ankle, elbow, hip, shoulder, MTP
Erosion/destruction	Absent	Present
Clinical course	Early in IBD disease course, acute and self-limiting (mostly under 10 wk)	Arthritis for months, episodic exacerbation for yr
Disease characters
IBD activity	Parallel with activity	Independent of activity
Other EIM	EN, uveitis	Uveitis
HLA association	HLA-B27, B35, DR*0103	HLA-B44
Treatment	Control of IBD activity, coxibs, CS, cDMARDs (SAZ 1st choice), TNF mAbs for refractory cases, JAKi for anti-TNF failure	Coxibs, CS, cDMARDs (SAZ 1st choice), TNF mAbs for refractory cases, JAKi for anti-TNF failure

CD: Crohn’s disease; cDMARD: Conventional disease-modifying antirheumatic drug; Coxib: Cyclooxygenase 2 inhibitor; EIM: Extra-intestinal manifestation; EN: Erythema nodosum; HLA: Human leukocyte antigen; IBD: Inflammatory bowel disease; JAKi: Janus kinase inhibitor; mAb: Monoclonal antibody; MCP: Metacarpophalangeal; MTP: Metatarsophalangeal; PIP: Proximal interphalangeal; PsA: Psoriatic arthritis; SAZ: Salazopyrin; S1PR: Sphingosine-1-phosphate receptor; TNF: Tumor necrosis factor; UC: Ulcerative colitis.