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NSAIDs in ankylosing spondylitis.

C Miceli-Richard¹, M Dougados

¹Rheumatology Department, René Descartes University, Paris, France.

Clinical and Experimental Rheumatology

|December 5, 2002

Summary

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) offer rapid symptom relief for Ankylosing Spondylitis (AS) but their long-term impact remains unclear. Current guidelines suggest intermittent use due to potential side effects and unknown disease progression.

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Area of Science:

Rheumatology
Pharmacology

Background:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are first-line treatments for Ankylosing Spondylitis (AS) due to rapid symptom relief.
The long-term effects of NSAIDs on AS prognosis and structural progression are not well understood.

Purpose of the Study:

To evaluate the short-term efficacy and explore the long-term implications of NSAID therapy in Ankylosing Spondylitis.
To clarify optimal NSAID dosage and treatment duration before classifying patients as refractory.

Main Methods:

Review of current literature on NSAID use in Ankylosing Spondylitis.
Analysis of short-term efficacy versus long-term prognosis and structural progression.
Consideration of gastrointestinal side effects and emerging Cox-2 inhibitors.

Main Results:

NSAIDs provide significant short-term relief for most AS patients.
Long-term prognosis and structural progression correlation with NSAID use requires further investigation.
Gastrointestinal side effects influence discontinuous NSAID treatment strategies.

Conclusions:

Intermittent NSAID use is common in AS due to rapid efficacy and concerns about long-term outcomes.
Newer Cox-2 inhibitors may alter treatment approaches.
Defining criteria for NSAID refractory patients is crucial for future management guidelines.

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