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Medication toxicity among patients with ankylosing spondylitis
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California 94034, USA. mward@leland.stanford.edu
Arthritis and Rheumatism
|July 13, 2002
Summary
Medication side effects are common in ankylosing spondylitis (AS) patients, but toxicity rarely leads to stopping antirheumatic drugs. This study compared toxicity across various AS medications.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Medicine
Background:
- Ankylosing spondylitis (AS) management involves antirheumatic treatments.
- Medication toxicity is a potential concern for treatment adherence and efficacy.
Purpose of the Study:
- To assess the frequency and impact of medication toxicity on discontinuing antirheumatic therapies in AS patients.
- To compare the toxicity profiles of commonly used AS medications.
Main Methods:
- A prospective longitudinal study involving 241 AS patients.
- Examined treatment duration and discontinuation rates due to side effects for sulfasalazine, methotrexate, and various NSAIDs (ibuprofen, naproxen, indomethacin, diclofenac, piroxicam, nabumetone, celecoxib).
Main Results:
- Side effects ranged from 6.7% (ibuprofen) to 47.3% (methotrexate).
- Discontinuation due to toxicity occurred in 2% (ibuprofen) to 23.5% (piroxicam) of courses.
- Piroxicam showed earlier discontinuation due to toxicity compared to other NSAIDs. Toxicity was not the primary reason for discontinuing most treatments.
Conclusions:
- Medication toxicity is frequently reported by AS patients.
- However, toxicity is an infrequent reason for discontinuing antirheumatic treatment in AS.