Sustained-release indomethacin in the management of ankylosing spondylitis

Ankylosing spondylitis is a systemic rheumatic disorder that is characterized by inflammation of the spine, sacroiliac, and large peripheral joints. Although back pain is the most frequent presenting symptom, disease can begin in peripheral joints--especially in children and women--and, rarely, even with acute iritis. Whatever the mode of onset, recurrent back pain that is frequently nocturnal and of varying intensity is an eventual complaint, as is early morning stiffness that is typically relieved by activity. The long-term prognosis is clearly enhanced by early diagnosis and patient education, both of which are central to preventing or minimizing disability. By suppressing articular inflammation, pain, and stiffness, the nonsteroidal anti-inflammatory drugs facilitate exercise and other supportive measures. Currently, among these agents, indomethacin occupies an important place. By virtue of its 12-hour dosage system, sustained-release indomethacin can be prescribed only once or twice daily, providing the anti-inflammatory efficacy of indomethacin while promoting patient compliance.