Pathophysiology and role of the gastrointestinal system in spondyloarthritides

Rheum Dis Clin North Am. 2012 Aug;38(3):569-82. doi: 10.1016/j.rdc.2012.08.012. Epub 2012 Sep 13.


Inflammatory bowel disease (IBD) is a well-known extra-articular manifestation in spondyloarthritis (SpA); about 6.5% of patients with ankylosing spondylitis develop IBD during the course of the disease. The pathogenesis of both SpA and IBD is considered to be the result of a complex interplay between the host (genetic predisposition), the immune system and environmental factors, notably microorganisms, leading to a disturbed immune system and chronic inflammation. Over the past decade, the role of tumor necrosis factor inhibition (infliximab, etanercept, adalimumab, golimumab) in improving signs and symptoms and overall quality of life has been well documented in various forms of SpA. Future research will clarify the role of other potential targets.

Publication types

  • Review

MeSH terms

  • Adalimumab
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Causality
  • Comorbidity
  • Etanercept
  • Health Status
  • Humans
  • Immunoglobulin G / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology*
  • Inflammatory Bowel Diseases / physiopathology*
  • Infliximab
  • Quality of Life
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Spondylarthritis / drug therapy
  • Spondylarthritis / epidemiology*
  • Spondylarthritis / physiopathology*
  • Spondylitis, Ankylosing / drug therapy
  • Spondylitis, Ankylosing / epidemiology
  • Spondylitis, Ankylosing / physiopathology
  • Treatment Outcome


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • golimumab
  • Infliximab
  • Adalimumab
  • Etanercept