Norfolk - Axial SPa Ibd REferral Tool (N-ASPIRE Tool) v1.0
Research type
Research Study
Full title
Axial Spondyloarthritis in Inflammatory Bowel Disease – secondary care cross-sectional prevalence and development of an evidence-base referral tool [Norfolk - Axial SPa Ibd REferral Tool (N-ASPIRE Tool)]
IRAS ID
223356
Contact name
Chong Seng Edwin Lim
Contact email
Sponsor organisation
Norfolk and Norwich University Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
This study will investigate how common a diagnosis of axial spondyloarthritis (axSpA) is in patients with known inflammatory bowel disease (IBD) such as Crohn’s Disease and Ulcerative Colitis. We hope to use information from the study to develop a tool to direct referral of patients with suspected axSpA in IBD patients to a rheumatology specialist.
IBD causes inflammation of the gut leading to symptoms such as diarrhoea, abdominal pain, back passage bleeding. AxSpA is a condition that causes inflammation in the spine resulting in back pain, stiffness, reduced range of spinal movement and fatigue. Recent research has shown that there are close associations between the two conditions. Because of advances in Magnetic Resonance Imaging (MRI), it is now possible to diagnose axSpA before changes become apparent on radiography (X-ray). However, this condition is still being diagnosed late because back pain is common and axSpA is a relatively uncommon cause of back pain. Identification strategies typically focus on patients in primary care, however there is an undefined population of undiagnosed patients with axSpA-associated conditions being seen in secondary care.
We feel that it is important to understanding how common axSpA is in IBD patients as the undiagnosed cases may represent a “hidden burden” of axSpA. This will then allow further analysis to facilitate the development of a referral tool to improve identification, thereby reducing the diagnostic delay and enable access to effective treatments.
Patients with a known diagnosis of IBD attending gastroenterology appointments are invited to participate in the study via a postal questionnaire. If patients are deemed eligible, participants will be invited to attend an assessment in the NNUH Rheumatology Department consisting of a medical interview, physical examination, blood tests, an X-ray, and a MRI scan of the back and pelvis. The research is funded in part by NASS (National-Ankylosing-Spondylitis-Society).
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
18/EE/0102
Date of REC Opinion
25 May 2018
REC opinion
Further Information Favourable Opinion