Characteristics, risk factors and disease course of musculoskeletal manifestations in patients with inflammatory bowel disease: a prospective longitudinal cohort study

Abstract

Abstract Background Musculoskeletal manifestations occur in half of the patients with Inflammatory bowel disease (IBD) and contribute to a reduced quality of life (QoL) and increased work disability. We aimed to evaluate the natural disease course, characteristics, and risk factors of musculoskeletal manifestations in patients with IBD. Methods We performed a prospective longitudinal cohort study in patients with IBD with and without musculoskeletal manifestations with a one year follow-up. Primary outcome was the proportion of patients with resolution of musculoskeletal manifestations. Secondary outcomes included: the proportion of patients with IBD that developed new musculoskeletal manifestations during follow-up; the correlation between IBD activity, baseline characteristics, and musculoskeletal disease course; and the difference in QoL between patients with and without musculoskeletal manifestations. Results In total, 243 patients with IBD were included (124 with and 119 without musculoskeletal manifestations). In the majority of patients (62.2%), musculoskeletal manifestations were of non-inflammatory nature. Overall, peripheral and axial manifestations were persistent in 85.7% and 44.6% at 1 year, respectively. The QoL at baseline and at 1 year was lower in the group with musculoskeletal manifestations compared to patients without these manifestations. Female gender and age above 40 were associated with the presence of musculoskeletal manifestations. Conclusion Musculoskeletal manifestations in patients with IBD are mostly non-inflammatory disorders, persist at 1 year of follow-up and occur more frequently in patients of age above 40 and female gender. Overall, patients with musculoskeletal manifestations have lower QoL compared to patients without musculoskeletal manifestations.