Response to: Correspondence on "ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update" by Braun et al

We read with interest the letter by Braun1 pertaining to the 2022 update of the ASAS-EULAR recommendations for the management of axial spondyloarthritis (axSpA).2 Braun questions whether having non-steroidal anti-inflammatory drugs (NSAIDs) as the first mandatory pharmacological treatment is still appropriate. First, doubt is raised whether an insufficient response to NSAIDs, which is required in daily clinical practice and in clinical studies before the start of biological disease-modifying antirheumatic drugs (bDMARDs), is ever formally checked. Whether this is the case or not, we remain firmly of the opinion that this could not, at least without a proof against, be an argument used to delete this from our recommendations. This opinion is based on the well documented and extensive evidence on the efficacy of NSAIDs in axSpA, over long periods of time. Furthermore, Braun indicates that tumour necrosis factor inhibitors (TNFi) reduce axial inflammation while NSAIDs...

Source: Annals of the Rheumatic Diseases - August 11, 2023 Category: Rheumatology Authors: Ramiro, S., Nikiphorou, E., Sepriano, A., Ortolan, A., Webers, C., Baraliakos, X., Landewe, R. B., van der Heijde, D. Tags: ARD Correspondence response Source Type: research