Dig Liver Dis. 2024 Dec 28:S1590-8658(24)01129-0. doi: 10.1016/j.dld.2024.12.010.Online ahead of print.

Luca Scarallo ¹, Valerio Maniscalco ², Edoardo Marrani ², Marina Aloi ³, Patrizia Alvisi ⁴, Serena Arrigo ⁵, Matteo Bramuzzo ⁶, Sabrina Cardile ⁷, Dario Dilillo ⁸, Enrico Felici ⁹, Francesco Graziano ¹⁰, Massimo Martinelli ¹¹, Lorenzo Norsa ¹², Claudio Romano ¹³, Saverio Pochesci ¹⁴, Giovanna Zuin ¹⁵, Gabriele Simonini ¹⁶, Paolo Lionetti ¹⁷

Author information

¹Department NEUROFARBA University of Florence, Italy; Gastroenterology and Nutrition Unit, Meyer Children's Hospital IRCCS, Florence, Italy.

²Rheumatology unit, ERN ReCONNET center, Meyer Children's Hospital IRCCS, Florence, Italy.

³Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy.

⁴Pediatric Gastroenterology Unit, Pediatric Department, Maggiore Hospital, Bologna, Italy.

⁵Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

⁶Department of Pediatrics, Institute for Maternal and Child Health, IRCSS Burlo Garofolo, Trieste, Italy.

⁷Gastroenterology, Digestive Endoscopy and Nutrition Unit, Bambino Gesù Children's Hospital, Rome, Italy.

⁸Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.

⁹Unit of Pediatrics, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

¹⁰Pediatric Unit, Villa Sofia Cervello Hospital, Palermo, Italy.

¹¹Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.

¹²Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy; The Pediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIIII, Bergamo, Italy.

¹³Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology, University of Messina, Messina, Italy.

¹⁴Gastroenterology and Nutrition Unit, Meyer Children's Hospital IRCCS, Florence, Italy.

¹⁵MBBM Foundation, Pediatric Department, Hospital San Gerardo, University of Milano Bicocca, Monza, Italy.

¹⁶Department NEUROFARBA University of Florence, Italy; Rheumatology unit, ERN ReCONNET center, Meyer Children's Hospital IRCCS, Florence, Italy.

¹⁷Department NEUROFARBA University of Florence, Italy; Gastroenterology and Nutrition Unit, Meyer Children's Hospital IRCCS, Florence, Italy. Electronic address: paolo.lionetti@unifi.it.

Abstract

Background and aims: The aim of the present study was to assess prevalence and disease outcomes of arthritis in a nationwide cohort of pediatric patients with inflammatory bowel disease (IBD).

Methods: We collected data of pediatric IBD patients experiencing arthritis from the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition IBD registry. We gathered baseline and one-year follow-up data on concomitant IBD and arthritis diagnosis.

Results: 150 patients [(99 Crohn's Disease (CD), 51 Ulcerative Colitis (UC) and Unclassified IBD (IBDU)] with arthritis out of 3061 (1301 CD and 1760 UC) patients were identified, with an overall prevalence of 4.9 %. Arthritis was more frequent in CD than in UC (7.6 % vs 2.9 %, p < 0.01). Peripheral arthritis was more frequently diagnosed in patients with active IBD than in those with quiescent disease (94.6 % vs 67.3 %, p < 0.01). At one-year follow-up, clinically active IBD was independently associated with lower peripheral arthritis remission rates, whereas it did not impact axial arthritis remission. The presence of additional EIMs was associated with lower IBD clinical remission rates.

Discussion: Clinically active IBD impacts peripheral arthritis but not axial one, whose activity appeared to be independent by intestinal disease. The presence of additional EIMs has a negative prognostic impact on IBD course.