Efficacy of diclofenac in ankylosing spondylitis

Ankylosing spondylitis is a systemic rheumatic disorder characterized by inflammation of the spine, sacroiliac, and large peripheral joints. Effective management demands both immediate and long-term objectives. The physician must first relieve joint inflammation and discomfort with nonsteroidal anti-inflammatory drugs, then begin long-range planning with daily exercise and other supportive measures to prevent, delay, or correct deformity. Diclofenac sodium, a nonsteroidal anti-inflammatory drug that is used worldwide in ankylosing spondylitis, has not yet been marketed in the United States. This article highlights two American studies with diclofenac: (1) a short-term, double-blind comparison with indomethacin, and (2) a 38-week extension with diclofenac for long-term efficacy and safety data. The results of these trials demonstrate diclofenac to be effective and safe for both short- and long-term treatment. When compared with indomethacin, a standard reference drug in trials of ankylosing spondylitis, diclofenac was comparable in efficacy but had a more favorable side-effect profile.