Inflammatory bowel diseases
October 1, 2026 · via Europe PMC
Advanced therapies for extraintestinal manifestations of IBD: a systematic review and meta-analysis.
Sachdeva K, Manik D, Chhibba T, Ananthakrishnan A.
AI summary — for doctors, generated from the abstract only
TNF antagonists, JAK inhibitors and anti-IL agents work well for joint and skin EIMs in IBD, while vedolizumab works less well.
What was studied
Systematic review and meta-analysis of 49 studies of advanced therapies for musculoskeletal, dermatologic and ocular EIMs.
Key findings
- TNF antagonists improved 61% of musculoskeletal EIMs (73% peripheral, 57% axial); JAK inhibitors 65%
- Vedolizumab 42%, only 12% for axial arthritis
- Dermatologic improvement 89% with TNF antagonists and 91% with anti-IL; ocular data scarce
Clinical relevance
Helps pick therapy for IBD patients with EIMs.
Who should care
Limitations
Mostly observational studies (42 of 49) with heterogeneity.
Prefer systemically active agents for patients with axial arthritis or skin EIMs.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background and aims
Extraintestinal manifestations (EIMs) occur in one-fifth of patients with inflammatory bowel diseases (IBDs) (Crohn's disease[CD]; ulcerative colitis [UC]). As advanced therapies (ATs) for IBD become more targeted, effectiveness for luminal disease may not be extrapolatable to EIMs. We conducted a systematic review to evaluate the efficacy of ATs on EIMs in IBD.
Methods
We conducted searches in PubMed/Embase (inception March 2025) for studies of any of the 5 FDA approved AT classes (tumor necrosis factor [TNF] antagonists, Janus kinase [JAK] inhibitors, anti-integrins, anti-interleukins [anti-ILs], and S1P receptor modulators) for musculoskeletal (arthritis, arthralgias), dermatologic (erythema nodosum, pyoderma gangrenosum), or ocular EIMs in patients with IBD. The primary outcome was clinical improvement. The pooled improvement rates by EIM type and AT class were calculated using a random effects model to account for anticipated heterogeneity.
Results
A total of 49 studies were included in the final analysis (6 randomized clinical trials [RCTs], 1 pooled analysis of clinical trials, and 42 observational studies). For musculoskeletal EIMs, TNF antagonists achieved response in 61% of patients, with higher response rates for peripheral (73%) than axial (57%) arthritis. JAK inhibitors were similarly effective (65%) while vedolizumab had significantly lower efficacy (42% improvement), particularly for axial arthritis (12%). For dermatologic EIMs, systemically directed ATs had high efficacy (TNF antagonists 89%, anti-IL 91%). There was a paucity of data on ocular EIMs.
Conclusion
Systemically directed ATs (TNF-antagonists, JAK inhibitors, anti-ILs) demonstrated strong efficacy for musculoskeletal or cutaneous EIMs; vedolizumab achieved clinical response in lower rates, particularly for axial arthritis.
DOI
10.1093/ibd/izag075
PMID
42108201
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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