Clinical and epidemiological research Extended report Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis

Information sourced from BMJ: Ann Rheum Dis 2012;71:1616-1622 doi:10.1136/annrheumdis-2011-201252 [Link to free full-text Ann Rheum Dis article PDF | PubMed ® abstract]

Clinical and epidemiological research Extended report Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort Denis Poddubnyy, Martin Rudwaleit, Hildrun Haibel, et al Correspondence to Joachim Sieper, Med. Department I, Rheumatology, Charite €“ Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany; joachim.sieper@charite.de Abstract Objective To investigate the influence of non-steroidal anti-inflammatory drugs (NSAIDs) intake on radiographic spinal progression over 2 years in patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (SpA). Methods 164 patients with axial SpA (88 with AS and 76 with non-radiographic axial SpA) were selected for this analysis based on availability of spinal radiographs at baseline and after 2 years of follow-up and the data on NSAIDs intake. Spinal radiographs were scored by two trained readers in a concealed randomly selected order according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) system. An index of the NSAID intake counting both dose and duration of drug intake was calculated. Results High NSAIDs intake (NSAID index ‰¥50) in AS was associated with lower likelihood of significant radiographic progression defined as an mSASSS worsening by ‰¥2 units: OR=0.15, 95% CI 0.02 to 0.96, p=0.045 (adjusted for baseline structural damage, elevated C reactive protein (CRP) and smoking status) in comparison with patients with low NSAIDs intake (NSAID index<50). This effect was most pronounced in patients with baseline syndesmophytes plus elevated CRP: mean mSASSS progression was 4.36 ±4.53 in patients with low NSAIDs intake versus 0.14 ±1.80 with high intake, p=0.02. In non-radiographic axial SpA, no significant differences regarding radiographic progression between patients with high and low NSAIDs intake were found. Conclusion A high NSAIDs intake over 2 years is associated with retarded radiographic spinal progression in AS. In non-radiographic axial SpA this effect is less evident, probably due to a low grade of new bone formation in the spine at this stage. Copyright © 2012 BMJ Publishing Group Ltd & European League Against Rheumatism. All rights reserved. The above message comes from BMJ, who is solely responsible for its content. You have received this email because you requested follow-up information to an Epocrates DocAlert ® Message. For more information about DocAlert ® Messages, please click here.

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