Biologics for Inflammatory Bowel Disease

Health experts have long known that if you have one autoimmune/autoinflammatory disease you face an above average risk of developing another. For people with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, that additional condition might very well turn out to be some type of inflammatory arthritis. Anywhere from 6 percent to 53 percent of IBD patients are believed to also have a joint disease. 

To further pin down this connection as well as to learn about how patients with multiple diseases are being treated, researchers from Wayne State University and Detroit Medical Center analyzed data on IBD patients who were seen in their outpatient clinic, as well as a larger data set taken from the National Inpatient Sample (NIS). They presented their findings at the recent Crohn’s & Colitis Congress in Denver and published them in a special supplement to the journal Inflammatory Bowel Diseases. 

The researchers determined that 9 percent of the 228 IBD patients treated in their clinic also had a rheumatic condition, most commonly ankylosing spondylitis (AS). (About 8 percent had AS and about 1 percent had rheumatoid arthritis, or RA.)  

The larger analysis, using data from the NIS, found that 6 percent of 65,000 IBD inpatients had a rheumatic disease; for this group, RA was most common (about 3 percent) rheumatic condition, followed by AS (less than one percent). 

IBD symptoms typically include chronic diarrhea, bloody stool, stomach pain, weight loss, and fatigue.  

Rheumatoid arthritis is best known for causing joint pain, stiffness, and swelling, especially in the hands and feet. Ankylosing spondylitis is also a type of inflammatory arthritis, but it’s more apt to cause pain, swelling, and stiffness in the lower back or in the joints that connect the pelvic to the spine (sacroiliac joints). 

Getting Treated for Multiple Conditions

The authors also determined that most patients who had IBD as well as AS or RA had been seen by specialists in both gastroenterology and rheumatology, which they noted was “encouraging.”  

The portion of the study that focused on patients who were treated at Wayne State, the majority of whom (77 percent) were described as African American. Participants from the NIS database, in contrast, were 81 percent Caucasian.  

Whether or not race impacts the discrepancy between the prevalence of RA and AS among IBD patients in these data sets isn’t clear. Although most IBD patients are non-Hispanic Whites, incidence among Black people is increasing.  

What’s more, Black patients with IBD tend to have more severe disease and related complications. AS and RA are also more common among Whites, but again, Black patients who develop these conditions tend to have higher levels of disease activity 

Although some IBD medications may also be used to treat inflammatory arthritis such as RA and AS, getting the correct diagnosis — or diagnoses — is crucial to ensuring you get the best care. Seeing specialists who are well-versed in these conditions and can work together to coordinate your treatment is also ideal. 

Both gastroenterologists and rheumatologists should be vigilant to identify the co-existence of these conditions and follow-up these patients for better outcomes,” the Wayne State University researchers noted.  

Gut Culture Podcast

The Gut Culture podcast gut checks assumptions about IBD (Inflammatory Bowel Disease) through real conversations with two health care leaders. The Global Healthy Living Foundation (GHLF) with over 2 decades of experience advocating for chronic disease patients joins forces and voices with the Color of Crohn’s and Chronic Illness (COCCI), a nonprofit organization founded by Health Advocate and Crohn’s Patient Melodie Narain-Blackwell. Listen now.


Nguyen GC, et al. National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States. J Crohns Colitis. 2013. doi:

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