Treatment of IBD Associated Spondyloarthritis
| Drug | Peripheral SpA | Axial SpA |
|---|---|---|
| NSAIDs a | Yes | Yes |
| Systemic Corticosteroids Intraarticular Corticosteroids | Yes Yes | No Only for sacroiliitis |
| Sulfasalazine Mesalamine | Yes No | No No |
| Methotrexate | Yes | No |
| Azathioprine/6MP | No | No |
| Biologics TNF inhibitors b 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.
