In patients with CD and active ankylosing spondylitis scheduled for subtotal colectomy, should spontaneous postoperative resolution of the spondylitis be expected or biologic therapy continued

What is known

- Case reports describe severe concomitant ankylosing spondylitis and Crohn's disease improving with infliximab, an anti-TNF agent. ^1,2 - In a patient with refractory Crohn's disease and concomitant ankylosing spondylitis, both remained clinically active despite multiple biologic and small-molecule therapies, and were addressed with combination biologic therapy rather than surgery. ³ - Ankylosing spondylitis and Crohn's disease co-occur, with ankylosing spondylitis reported in roughly 4-10% of IBD patients. ¹

What is unknown / caveats

- Evidence is limited to case reports and cohort descriptions; no study in the excerpts directly tracks ankylosing spondylitis activity before versus after colectomy - Excerpts do not address perioperative continuation, holding, or timing of biologic therapy around subtotal colectomy - The excerpts do not directly measure ankylosing spondylitis activity after colectomy, so the expectation of non-resolution is inferred from its independent, axial course and treatment reports.

## References

1. Rebelo A, Leite S, Cotter J. Association of ankylosing spondylitis and Crohn's disease successfully treated with infliximab. BioDrugs. 2010. PMID: 21175236.

2. Rednic S, Marinescu C, Chira R, Rogojan L, Rednic N. Treatment with infliximab in a patient with ankylosing spondylitis and Crohn's disease. J Gastrointestin Liver Dis. 2006. PMID: 17205151.

3. Vieujean S, Peyrin-Biroulet L. Triple biologic therapy for refractory Crohn's disease. J Crohns Colitis. 2025;19(5):ePub only. PMID: 40251965.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._