COMPARISON OF THE EFFECT OF TREATMENT WITH NSAIDS ADDED TO ANTI-TNF THERAPY VERSUS ANTI-TNF THERAPY ALONE ON PROGRESSION OF STRUCTURAL DAMAGE IN THE SPINE OVER TWO YEARS IN PATIENTS WITH ANKYLOSING SPONDYLITIS (CONSUL) – AN OPEN-LABEL, RANDOMIZED CONTROLLED, MULTICENTER TRIAL
Abstract: OP0018
Authors: F. Proft et al.
Key content:
There is some evidence that NSAIDs may slow radiographic progression in ankylosing spondylitis (see also OP0021 EULAR 2022). Also for TNF-inhibitors retardation of radiographic progression was shown, at least in patients with 4 years or more of therapy. Whether NSAIDs have an additional benefit to anti-TNF therapy for prevention of structural damage in the spine is unknown. This randomized controlled trial evaluated the radiographic progression by mSASSS after 2 years of therapy with a TNF-inhibitor with or without additional therapy with Celecoxib. There were no significant differences in the mSASSS between the two groups, but a tendency for a lower number of new syndesmophytes in the combination group.
Relevance:
This data reminds me of the pivotal studies of Costadino Pitzalis group studying synovial tissue in RA patients that The data suggest that combination therapy with a TNF inhibitor and NSAIDs, with the aim of lowering radiographic progression, cannot be generally recommended. However, based on a tendency of fewer syndesmophytes seen in the study, could be considered in patients at high risk for progression.
