Multidisciplinary management of patients with coexisting inflammatory bowel disease and spondyloarthritis : a Delphi consensus among Italian experts

BACKGROUND: Treatment of patients with coexisting spondyloarthritis (SpA) and inflammatory bowel disease (IBD) often requires multidisciplinary collaboration between gastroenterologists and rheumatologists. AIM: To describe the results of the first Delphi consensus to define shared therapeutic strategies for the best management of patients with coexisting SpA and IBD. METHODS: A scientific steering committee of 10 Italian experts in the field of SpA and IBD developed 27 statements on 5 possible clinical scenarios and selected 40 specialists from across Italy, both gastroenterologists and rheumatologists, to vote them using a Delphi method. Each participant expressed a level of agreement on each statement using a 5-point scale (1="absolutely disagree"; 5="absolutely agree"). Total cumulative agreement was defined as the sum of the percentage of responses to items 4 ("agree") and 5 ("absolutely agree"). Total cumulative agreement ≥70% defined consensus for each statement. RESULTS: After the first round, positive consensus was reached for 22 statements. Statements without consensus were discussed in a plenary session before the second vote. Positive consensus was then reached in all statements, with final total cumulative agreement ranging from 80% to 100%. CONCLUSION: This is the first Delphi consensus defining specific treatment algorithms for patients with coexisting SpA and IBD.