Treatment of IBD Associated Spondyloarthritis

Treatment of IBD Associated Spondyloarthritis

DrugPeripheral SpAAxial SpA
NSAIDs aYesYes
Systemic Corticosteroids
Intraarticular Corticosteroids
Yes
Yes
No
Only for sacroiliitis
Sulfasalazine
Mesalamine
Yes
No
No
No
MethotrexateYesNo
Azathioprine/6MPNoNo
Biologics
TNF inhibitors Vedolizumab c
Secukinumab d
Ustekinumab
Yes No
Yes
Yes
Yes No
Yes
Yes
Bowel Resection
Crohn’s
UC
No
Only for Type 1
No
No

a Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate IBD. Cox-2 selective NSAIDs may be safer.

b tumor necrosis factor (TNF) α inhibitors that are approved and effective include infliximab, adalimumab, golimumab, and certolizumab pegol. Etanercept is ineffective for IBD.

c There have been reports of SpA developing in the setting of vedolizumab.

d Secukinumab should be used with caution in patients with IBD as cases were observed to occur in clinical trials as was worsening of established IBD.

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