Treatment of arthralgias and spondyloarthropathy associated with inflammatory bowel disease

Joint involvement is the most frequent extraintestinal manifestation of inflammatory bowel diseases (IBDs). Arthralgias are common and spondyloarthropathy may affect peripheral joints and the axial skeleton, as well as the tendons. The broad spectrum of joint manifestations requires a therapeutic concept that takes the potential influence of agents on the underlying bowel disease into consideration. This review will focus on the current therapeutic approach to the different manifestations of IBD-related joint disease and will outline baseline treatment, the use of conventional agents and biologicals. TNF antagonists have dramatically changed the care of patients. In particular, TNF antagonists have emerged as the most effective treatment for ankylosing spondylitis, which has often been refractory to therapy in the past. For patients who fail to respond to TNF antagonists, several novel agents will provide more treatment choices in the future. Recent insights into disease mechanisms of IBD have revealed at...