ACR 2020 | Daily Highlights

COX-2 inhibitors and radiographic progression

TREATMENT WITH SELECTIVE CYCLOOXYGENASE-2 INHIBITORS IS ASSOCIATED WITH INHIBITION OF RADIOGRAPHIC SPINAL PROGRESSION IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: LONG-TERM RESULTS FROM THE GERMAN SPONDYLOARTHRITIS INCEPTION COHORT

Abstract: 2030
Authors: Denis Poddubnyy et al.

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Key content:
Whether the intake of NSAIDs prevents radiographic progression in axSpA is controversial. Previous trials with COX-2 selective inhibitors have shown a beneficial effect which could not be confirmed in a randomized trial with a non-selective COX inhibitor. In this study the authors have analyzed the effect of COX-2 selective inhibitors on radiographic progression (mSASSS) in the german spondyloarthritis inception cohort (GESPIC) as compared to non-selective NSAID. Radiographs at least 2 years apart over a period of 10 years were scored. The intake of COX-2 selective inhibitors was associated with a lower radiographic progression as compared to non-selective NSAID. The association with lower mSASSS progression remained after adjusting for NSAID intake score, TNF-inhibitor treatment and disease activity.

Relevance:
This observational study suggests that inhibition of radiographic progression in axSpA, previously reported in a randomized trial, is a specific effect of COX-2 inhibition. The results would support the use of COX-2 selective inhibitors in axSpA, however, long-term treatment with these drugs needs to be evaluated on an individual basis considering the risks and benefit.

Zusammenfassung und Kommentar von:
Prof. Dr. Diego Kyburz
Basel