TREATMENT WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS IS ASSOCIATED WITH RETARDATION OF RADIOGRAPHIC SPINAL PROGRESSION IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: 10-YEAR RESULTS FROM THE GERMAN SPONDYLOARTHRITIS INCEPTION COHORT
Authors: Murat Torgutalp et al.
Previous studies have shown an effect of non-steroidal anti-rheumatic drugs (NSAID) on radiographic progression in axSpA. This study from the german Gespic cohort extended previous studies with comparisons of nr-axSpA and r-axSpA as well as of non-selective (NS) NSAID with selective COX2 inhibitors. 243 patients (130 nr-axSpA and 113 r-axSpA) for which radiographs were available during a ten year follow up were included in the analysis. NSAID dose and duration of treatment was counted in the ASAS index of NSAID intake. Radiographic progression was defined as absolute mSASSS change score over 2 years. In adjusted multivariable analysis a significant association of higher NSAID intake and retardation of radiographic progression was shown. The effect was seen mainly in r-axSpA, less in nr-axSpA. mSASSS progression was numerically lower in COX2 treated patients as compared to NS NSAID.
This study shows, that higher NSAID intake is associated with lower radiographic progression in axSpA, in particular in r-axSpA. The effects may even be more marked with COX2 inhibitors. Therefore, COX inhibitors seem to be a good choice in patients with r-axSpA.