Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab

• Published in: Rheumatology (Oxford, England) Vol. 59; no. 11; pp. 3275 - 3283
• Main Authors: Dupré, Anastasia, Collins, Michael, Nocturne, Gaétane, Carbonnel, Franck, Mariette, Xavier, Seror, Raphaèle
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.11.2020
• Subjects: Adolescent; Adult; Aged; Antibodies, Monoclonal, Humanized - adverse effects; Arthralgia - chemically induced; Chondrocalcinosis - chemically induced; Colitis - drug therapy; Colitis, Ulcerative - complications; Colitis, Ulcerative - drug therapy; Crohn Disease - complications; Crohn Disease - drug therapy; Female; Follow-Up Studies; Gastrointestinal Agents - adverse effects; Humans; Inflammatory Bowel Diseases - complications; Inflammatory Bowel Diseases - drug therapy; Joint Diseases - chemically induced; Male; Middle Aged; Retrospective Studies; Spondylarthritis - chemically induced; Tumor Necrosis Factor Inhibitors - therapeutic use; Young Adult; spondyloarthritis; vedolizumab; ulcerative colitis; Crohn’s disease
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/keaa107

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.