{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:07:12Z","timestamp":1789387632547,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82160878"],"award-info":[{"award-number":["82160878"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81960866"],"award-info":[{"award-number":["81960866"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Ulcerative colitis (UC) is a manifestation of inflammatory bowel disease (IBD), which can cause inflammation of the intestinal tract. Ankylosing spondylitis (AS) is an inflammatory disease of the sacroiliac joints. Many studies have found that some UC patients progress to AS. In this study, we conducted a literature search and meta-analysis to investigate the prevalence of AS among UC patients during follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The studies related to the AS among patients with UC were obtained from PubMed, Web of Science, Embase, and Cochrane Library databases since its inception-December 2022. The literature was screened strictly according to inclusion and exclusion criteria. Forest plots were used to detect the overall incidence of AS in UC and to compare the risk ratios for the development of AS in the UC. The heterogeneity of studies was assessed using I<jats:sup>2<\/jats:sup> statistical methods.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>1) 17 studies with 98704 UC patients were included. 2)700 UC patients developed AS during follow-up (1.66%, 95% CI: 0.89\u20132.62%). Human leukocyte antigen B27 (HLA-B27) was reported in 3 studies. HLA-B27 positivity was significantly higher than the incidence of HLA-B27 negativity in AS patients (68.29% vs 31.71%, P &lt; 0.0001). There was significantly increased risk of AS development in HLA-B27 positive IBD patients (RR: 22.17, 95% CI: 11.79\u201341.66, P &lt; 0.0001). 3)The definite follow-up time was reported in 12 studies (range: 0.3\u201340 years). After follow-up for \u22655 years, the incidence of AS among patients with UC was 1.75% (95% CI: 0.62\u20133.37%). Meanwhile, after follow-up for &lt;5 years, the incidence of AS among patients with UC was 1.41% (95% CI: 0.65\u20132.37%) which was significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Patients with UC are more likely to develop AS in the future. Furthermore, the IBD patients are at a higher risk of AS who have positive HLA-B27. The incidence of AS increased with longer follow-up time.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0289021","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T17:30:45Z","timestamp":1690911045000},"page":"e0289021","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Development of ankylosing spondylitis in patients with ulcerative colitis: A systematic meta-analysis"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8711-6956","authenticated-orcid":true,"given":"Aitao","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongyi","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyu","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"issue":"11","key":"pone.0289021.ref001","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1001\/jamapediatrics.2015.1982","article-title":"Inflammatory bowel disease in children and adolescents","volume":"169","author":"MJ Rosen","journal-title":"JAMA Pediatr2015"},{"issue":"2","key":"pone.0289021.ref002","first-page":"135","article-title":"Ulcerative colitis: an update","volume":"21","author":"P Jonathan","year":"2021","journal-title":"Clin Med (Lond)."},{"key":"pone.0289021.ref003","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/s41572-020-0205-x","article-title":"Ulcerative colitis.","volume":"6","author":"T Kobayashi","year":"2020","journal-title":"Nat Rev Dis Prim"},{"key":"pone.0289021.ref004","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1097\/MIB.0000000000000392","article-title":"Extraintestinal manifestations of inflammatory bowel disease","volume":"21","author":"SR Vavricka","year":"2015","journal-title":"Inflammation Bowel Dis"},{"issue":"4","key":"pone.0289021.ref005","first-page":"655","article-title":"Ulcerative Colitis Making the Diagnosis.Gastroenterol Clin North Am","volume":"49","author":"Tanyaporn Kaenkumchorn","year":"2020"},{"key":"pone.0289021.ref006","volume-title":"Pediatric gastrointestinal and liver disease","author":"R Wyllie","year":"2015","edition":"5"},{"issue":"6","key":"pone.0289021.ref007","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders","volume":"11","author":"F Magro","year":"2017","journal-title":"J Crohns Colitis"},{"key":"pone.0289021.ref008","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/nrrheum.2017.56","article-title":"Pathogenesis of ankylosing spondylitis-recent advances and future directions.","volume":"13","author":"V Ranganathan","year":"2017","journal-title":"Nat Rev Rheumatol"},{"key":"pone.0289021.ref009","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1016\/S0140-6736(07)60635-7","article-title":"Ankylosing spondylitis","volume":"369","author":"J Braun","year":"2007","journal-title":"Lancet"},{"key":"pone.0289021.ref010","first-page":"451","article-title":"Ankylosing spondylitis and bowel disease. Best pract.","volume":"20","author":"M Rudwaleit","year":"2006","journal-title":"res.Clin Rheumatol"},{"key":"pone.0289021.ref011","first-page":"631","article-title":"The Prevalence and Incidence of Axial and Peripheral Spondyloarthritis in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis","author":"M. C. Karreman","year":"2017","journal-title":"Journal of Crohn\u2019s and Colitis"},{"key":"pone.0289021.ref012","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/BOR.0b013e3283393807","article-title":"Interactions between gut inflammation and arthritis\/spondylitis","volume":"22","author":"P Jacques","year":"2010","journal-title":"Curr Opin Rheumatol"},{"key":"pone.0289021.ref013","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"A Liberati","year":"2009","journal-title":"Br. Med. J"},{"issue":"3","key":"pone.0289021.ref014","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1440-1746.2010.06241.x","article-title":"The Asia-Pacific consensus on ulcerative colitis.","volume":"25","author":"Kwong Ming Fock Choon Jin Ooi","year":"2010","journal-title":"J Gastroenterol Hepatol"},{"issue":"9","key":"pone.0289021.ref015","first-page":"603","article-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses","volume":"25","author":"G Wells","year":"2000","journal-title":"Eur JEpidemiol"},{"key":"pone.0289021.ref016","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses. BMJ","volume":"327","author":"JP Higgins","year":"2003","journal-title":"British Medical Journal"},{"key":"pone.0289021.ref017","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/art.1780270401","article-title":"Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria","volume":"27","author":"S van der Linden","year":"1984","journal-title":"Arthritis Rheum"},{"issue":"9","key":"pone.0289021.ref018","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1136\/gut.11.9.748","article-title":". Arthropathy, ankylosing spondylitis, and clubbing of fingers in ulcerative colitis","volume":"11","author":"R K N Jalan","year":"1970","journal-title":"Gut"},{"issue":"12","key":"pone.0289021.ref019","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1080\/003655201317097173","article-title":"Musculoskeletal Manifestations in a Population-based Cohort of Inflammatory Bowel Disease Patients.","volume":"36","author":"C. Salvarani","year":"2001","journal-title":"Scand JGastroenterol,"},{"issue":"3","key":"pone.0289021.ref020","first-page":"511","article-title":"Prevalence of Ankylosing Spondylitis and OtherSpondyloarthropathies Among Patients with Inflammatory Bowel Disease: A Population Study (The IBSEN Study).","volume":"29","author":"PALM \u00d8YVIND","year":"2002","journal-title":"J Rheumatol"},{"issue":"1","key":"pone.0289021.ref021","first-page":"16","article-title":"Arthritis associated with bowel disease in children.JPediatr","volume":"84","author":"B Lindsley C","year":"1974"},{"key":"pone.0289021.ref022","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1007\/s00296-008-0811-5","article-title":"Prevalence of spondyloarthritis in Turkish patients with inXammatory bowel disease.","volume":"29","author":"Asli Beslek","year":"2009","journal-title":"Rheumatol Int"},{"key":"pone.0289021.ref023","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.3899\/jrheum.121029","article-title":"Incidence of Spondyloarthropathy in Patients with Ulcerative Colitis: A Population-based Study","volume":"40","author":"R Shivashankar","year":"2013","journal-title":"J Rheumatol"},{"issue":"10","key":"pone.0289021.ref024","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.gastrohep.2015.04.003","article-title":"Incidencia a los 2 anos de nuevas enfermedades inflamatorias mediadas por inmunidad en la cohorte de pacientes con enfermedad inflamatoria intestinal del estudio AQUILES.","volume":"38","author":"Mar\u00edn-Jim\u00e9nez a Ignacio","year":"2015","journal-title":"Gastroenterol Hepatol."},{"issue":"9","key":"pone.0289021.ref025","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1007\/s10620-016-4195-1","article-title":"Extra-Gastrointestinal Manifestations of Inflammatory Bowel Disease May Be Less Common Than Previously Reported","volume":"61","author":"Timothy R. Card","year":"2016","journal-title":"Dig Dis Sci"},{"issue":"3","key":"pone.0289021.ref026","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1080\/14397595.2016.1211229","article-title":"Association of inflammatory bowel disease with ankylosing spondylitis and rheumatoid arthritis: A nationwide population-based study.","volume":"27","author":"M Bae J","year":"2017","journal-title":"Mod Rheumatol."},{"issue":"3","key":"pone.0289021.ref027","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s10067-017-3834-z","article-title":"Joint involvement in Mexican patients with ulcerative colitis:a hospital-based retrospective study.","volume":"37","author":"K. Jes\u00fas","year":"2018","journal-title":"Clin Rheumatol."},{"issue":"1","key":"pone.0289021.ref028","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/ecco-jcc\/jjx126","article-title":"Ankylosing Spondylitis and Axial Spondyloarthritis in Patients With Long-term Inflammatory Bowel Disease: Results From 20 Years of Follow-up in the IBSEN Study.","volume":"12","author":"M Ossum A","year":"2018","journal-title":"J Crohns Colitis."},{"issue":"33","key":"pone.0289021.ref029","doi-asserted-by":"crossref","first-page":"6137","DOI":"10.3748\/wjg.v23.i33.6137","article-title":"Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases","volume":"23","author":"L Halling M","year":"2017","journal-title":"World J Gastroenterol"},{"key":"pone.0289021.ref030","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2147\/CEG.S136383","article-title":"Characterization and prevalence of spondyloarthritis and peripheral arthritis among patients with inflammatory bowel disease.","volume":"10","author":"M Malaty H","year":"2017","journal-title":"Clin Exp Gastroenterol"},{"issue":"13","key":"pone.0289021.ref031","doi-asserted-by":"crossref","first-page":"2704","DOI":"10.1016\/j.cgh.2019.03.040","article-title":"Incidence of Immune-Mediated Inflammatory Diseases Among Patients With Inflammatory Bowel Diseases in Denmark","volume":"17","author":"J Burisch","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"4","key":"pone.0289021.ref032","doi-asserted-by":"crossref","first-page":"e0211554","DOI":"10.1371\/journal.pone.0211554","article-title":"The appearance of joint manifestations in the Swiss inflammatory bowel disease cohort.","volume":"14","author":"A Hiller","year":"2019","journal-title":"PLoS One"},{"issue":"44","key":"pone.0289021.ref033","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.3346\/jkms.2021.36.e278","article-title":"Severe Disease Activity Based on the Paris Classification Is Associated with the Development of Extraintestinal Manifestations in Korean Children and Adolescents with Ulcerative Colitis","volume":"36","author":"Hyo-Jeong Jang","year":"2021","journal-title":"J Korean Med Sci"},{"issue":"S256","key":"pone.0289021.ref034","volume":"43","author":"C. Corrado","year":"2011","journal-title":"Extraintestinal manifestations in a single centre cohort of chronic inflammatory bowel disease patients Digestive and Liver Disease"},{"key":"pone.0289021.ref035","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s00281-021-00845-0","article-title":"The gut-joint axis in spondyloarthritis:Immunological, microbial, and clinical insights.","volume":"43","author":"Z Qaiyum","year":"2021","journal-title":"Semin Immunopathol"},{"key":"pone.0289021.ref036","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.jbspin.2016.12.016","article-title":"Chronic bowel inflammation and inflammatory joint disease:Pathophysiology","volume":"84","author":"S Speca","year":"2017","journal-title":"Joint Bone Spine"},{"key":"pone.0289021.ref037","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.crohns.2009.11.005","article-title":"The joint-gut axis in inflammatory bowel diseases.","volume":"4","author":"L. Brakenhoff","journal-title":"J. Crohns Colitis"},{"key":"pone.0289021.ref038","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1002\/art.39802","article-title":"Brief report: Dialister as a microbial marker of disease activity in spondyloarthritis.","volume":"69","author":"R. Tito","year":"2016","journal-title":"Arthr. Rheum"},{"key":"pone.0289021.ref039","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1038\/s41584-020-0454-9","article-title":"Revisiting the gut-joint axis: Links between gut inflammation and spondyloarthritis","volume":"16","author":"E Gracey","year":"2020","journal-title":"Nat Rev Rheumatol"},{"issue":"3","key":"pone.0289021.ref040","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/art.38967","article-title":"Brief Report: Intestinal Dysbiosis in Ankylosing Spondylitis.","volume":"67","author":"E Costello M","year":"2015","journal-title":"Arthritis Rheumatol."},{"key":"pone.0289021.ref041","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1056\/NEJMra1406182","article-title":"Ankylosing spondylitis and axial spondyloarthritis","volume":"374","author":"JD Taurog","year":"2016","journal-title":"N Engl J Med"},{"issue":"4","key":"pone.0289021.ref042","doi-asserted-by":"crossref","first-page":"103297","DOI":"10.1016\/j.autrev.2023.103297","article-title":"Development of systemic lupus erythematosus in patients with immune thrombocytopenic purpura: A systematic meta-analysis","volume":"22","author":"N Pamuk O","year":"2023","journal-title":"Autoimmun Rev"},{"key":"pone.0289021.ref043","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1136\/annrheumdis-2012-202135","article-title":"Microscopic gut inflammation in axial spondyloarthritis: a multiparametric predictive model","volume":"72","author":"L. Van Praet","year":"2013","journal-title":"Ann. Rheum. Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0289021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T17:31:14Z","timestamp":1690911074000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0289021"}},"subtitle":[],"editor":[{"given":"Antoine Fakhry","family":"AbdelMassih","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":43,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0289021","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}