Table 1

Main characteristics of the most common immune-mediated inflammatory diseases

Rheumatoid arthritisSpondyloarthritisInflammatory bowel disease
Ankylosing spondylitisPsoriatic arthritisCrohn’s diseaseUlcerative colitis
Main clinical manifestations*
  • Arthritis ≥3 joints.

  • Elevated CRP and ESR.

  • Presence of RF and anti-CCP antibodies.

  • Male:female 1:2–3.

  • Onset in fourth, fifth or sixth decade.

  • Arthritis of SI and axial joints and ankylosis of spinal column.

  • Association with HLA-B27 genotype.

  • Elevated CRP and ESR in approximately 50%.

  • Male:female 3:1.

  • Onset generally before the age of 30†.

  • Inflammation of distal joints (DIPs > PIPs).

  • Psoriasis.

  • Slight predominance in men.

  • Onset 45–54 years.

  • Involvement of any portion of the GI tract.

  • Transmural inflammation.

  • Arthritis ~6%–14%.

  • Slight predominance in women.

  • Onset commonly <30 years, second peak in women 60–70 years.

  • Colon involvement.

  • Inflammation of mucosal layer.

  • Arthritis ~6%–14%.

  • Slight predominance in men.

  • Onset 30–40 years.

Treatment options
  • NSAIDs.

  • Oral/intra-articular glucocorticosteroids.

  • DMARDs.

  • Biologicals.

  • NSAIDs.

  • Oral/intra-articular glucocorticosteroids.

  • Biologicals.

  • NSAIDs.

  • Oral/intra-articular glucocorticosteroids.

  • DMARDs.

  • Biologicals.

  • Salicylates.

  • Oral glucocorticosteroids.

  • DMARDs.

  • Biologicals.

  • Operative.

  • Salicylates.

  • Oral glucocorticosteroids.

  • DMARDs.

  • Biologicals.

  • Operative.

CVD risk
  • Twofold increased mortality rate comparable with diabetes.

  • CVD main cause of death, mainly due to atherosclerotic disease.

  • Increased mortality rate.

  • CVD main cause of death.

  • Both atherosclerotic disease and specific cardiac manifestations.

  • Increased mortality rate.

  • Increased prevalence of MI.

  • Increased CVD risk, but not increased CVD mortality.

  • Increased CVD risk but not increased CVD mortality.

  • *This list includes the main clinical manifestations of IMIDs, but it is in no means a complete list of symptoms and IMIDs commonly have overlapping characteristics.

  • †Often delayed diagnosis due to lack of disease knowledge and misdiagnosis, especially in women.

  • anti-CCP, anticitrullinated protein antibody; CRP, C reactive protein; CVD, cardiovascular disease; DIPs, distal interphalangeal joints; DMARDs, disease-modifying antirheumatic drugs; ESR, erythrocyte sedimentation rate; GI, gastrointestinal; HLA-B27, human leucocyte antigen B27; IMIDs, immune-mediated inflammatory diseases; MI, myocardial infarction; NSAIDs, non-steroidal anti-inflammatory drugs; PIPs, proximal interphalangeal joints; RF, rheumatoid factor; SI, sacroiliac.