EXTRA-INTESTINAL RHEUMATOLOGICAL MANIFESTATIONS IN INFLAMMATORY BOWEL DISEASES

Kovalenko V.M., Bentsa T.M., Krylova A.S.

• Shupyk National University of Healthcare of Ukraine, Kyiv

Summary. Inflammatory bowel diseases (IBDs) is a systemic disease that manifests itself not only in the intestines, but also in the extraintestinal organs in many patients. The quality of life of patients may be completely disrupted by these extraintestinal manifestations (EIMs). EIMs can occur before the onset of intestinal symptoms, and need to be recognized to initiate appropriate diagnostic procedures. EIMs most frequently affect joints, skin or eyes, but can also affect other organs, such as the liver, lung, and pancreas. Rheumatological manifestations are identified as the most common EIMs, including axial and peripheral spondyloarthritis, arthralgia, sacroiliitis, enthesitis, and dactylitis. Spondyloarthritis (SpA) is one of the most common EIMs of IBD. The initial examination should include basic laboratory tests and instrumental methods, as well as non-invasive assessment of inflammation using additional biomarkers. In addition to its diagnostic specificity in differentiating IBD from other gastrointestinal diseases, calprotectin is emerging as a promising therapeutic target due to its dual role in modulating inflammatory pathways and interacting with the gut microbiota. Recently developed biologics allow for the simultaneous treatment of IBD and its EIMs. Anti-tumor necrosis factor monoclonal antibodies and Janus kinase inhibitors are effective drugs that are approved for the treatment of SpA and IBD. Close collaboration between gastroenterologists and rheumatologists is necessary with mutual referral of patients from early accurate diagnosis to appropriate and timely therapy of extraintestinal rheumatological manifestations of IBD.