DOP43 Impact of Inflammatory Bowel Diseases on the phenotype and severity of psoriasis and spondyloarthropathies
Bibliographic record
Abstract
Abstract Background It is unclear whether inflammatory bowel diseases (IBD) affect the phenotype and severity of co-occurring axial spondyloarthropathies (axSpA) and psoriasis. Therefore, we aimed to investigate the characteristics of axSpA and psoriasis in relation to co-occurring IBD. Methods The systematic review and meta-analysis were conducted according to Cochrane’s recommendations. PubMed and EMBASE were searched from database inception till January 2020 for studies reporting disease phenotype and severity of axSpA and psoriasis in association with co-occurrence of IBD. Meta-analyses were performed using a random-effects model. Quality of the studies was assessed by the Newcastle-Ottawa Scale (NOS). Results The electronic search yielded 12,220 studies which were narrowed down to 152 after screening based on study titles and abstracts. Of these, a full-text review identified 20 eligible studies, including twelve and eight studies describing characteristics of axSpA and psoriasis, respectively, in relation to IBD. AxSpA was identified among a total of 321 and 8,660 patients with and without a co-occurring IBD, respectively, and the studies’ mean NOS score was 6.8, including seven and five studies of moderate and high quality, respectively. The meta-analysis demonstrated that presence of co-occurring IBD was associated with an increased risk of dactylitis (risk ratio (RR)=2.06 (95%CI 1.24–3.42), I2=0%), but not enthesitis (RR=0.93 (95%CI 0.48–1.81), I2=86%). Furthermore, IBD was associated with a significantly lower Bath Ankylosing Spondylitis Radiology Index (mean difference (meandiff) -2.28 (95%CI -3.26-(-1.30)), p<0.01, I2=0%), better Schober’s test results (meandiff 0.80 (95%CI 0.64–1.49), p<0.01, I2=0%), and a lower finger to floor distance (meandiff -6.36 (95%CI -10.36-(-2.36)), p<0.01, I2=0%). The phenotype of psoriasis was assessed among 680 and 222,279 patients with and without a co-occurring IBD. The mean NOS score was 7.4, including two studies of moderate methodological quality, while the remaining six studies were of high quality. The presence of IBD was associated with a significantly less frequent presentation of psoriasis in the nails (RR=0.14 (95%CI 0.05–0.42), I2=0%) but not psoriatic arthritis (RR=0.94 (95%CI 0.27–3.31), I2=75%). Finally, the presence of IBD was associated with a milder phenotype of psoriasis (RR=1.41 (95%CI 1.02–1.96), p=0.04, I2=70%). Conclusion This is the first systematic review with meta-analysis investigating the impact of IBD on the disease phenotype and severity of psoriasis and axSpA. Our data suggest that IBD modifies psoriasis and axSpA to be milder and emphasizes the importance of a multidisciplinary approach to patients with psoriasis or axSpA and co-occurring IBD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.019 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.020 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".