Non ‐Steroidal Anti‐Inflammatory Drugs As Potential Disease Modifying Medications In Axial Spondyloarthritis

AbstractNon ‐steroidal anti‐inflammatory drugs (NSAIDs) are the first line pharmacotherapy for patients with axial spondyloarthritis (axSpA). In the recent years, treatment options have expanded with the availability of biologics, including tumor necrosis factor inhibitors (TNFi) and IL‐17 inhibitors. How ever, a treatment strategy that clearly prevents syndesmophyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently available medications for axSpA have an effect on spine radiographic progression, beyond symptom control, remains inconclusive. In this paper, we will review the clinical studies of NSAIDs and biologics on disease modification of axSpA, examine genetic, animal and clinical evidence of NSAID effects on bone formation, and discuss how future studies may investigate the question of disease modification in axSpA.

Source: Arthritis and Rheumatology - November 8, 2019 Category: Rheumatology Authors: Runsheng Wang, Joan M. Bathon, Michael M. Ward Tags: REVIEW ARTICLE Source Type: research