Ankylosing spondylitis disease activity score is related to NSAID use, especially in patients treated with TNF-alpha inhibitorsCarbo, M. J. G., Spoorenberg, A., Maas, F., Brouwer, E., Bos, R., Bootsma, H., van der Veer, E., Wink, F. & Arends, S., 24-Apr-2018, In : PLoS ONE. 13, 4, 12 p., e0196281.
Research output: Contribution to journal › Article › Academic › peer-review
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are regarded as the cornerstone of conventional treatment for AS. However little is known about concomitant NSAID use during treatment (with TNF-α inhibitors) in daily clinical practice.
METHODS AND FINDINGS: Consecutive patients from the GLAS cohort were included. NSAID use and ASAS-NSAID index were evaluated at group level and at individual patient level during 52 weeks of follow-up. Analyses were stratified for treatment regimen. Generalized estimating equations (GEE) was used to evaluate NSAID use in relation to assessments of disease activity over time. In patients starting TNF-α inhibitors (n = 254), 79% used NSAIDs at baseline and this proportion decreased significantly to 38% at 52 weeks. ASAS-NSAID index also decreased significantly from median 65 to 0. In patients on conventional treatment (n = 139), 74% used NSAIDs at baseline with median ASAS-NSAID index of 50 and this remained stable during follow-up. At each follow-up visit, approximately half of the patients changed their type or dose of NSAIDs. GEE analysis over time showed that NSAID use was associated with AS disease activity score (p<0.05). This relation was more pronounced in patients treated with TNF-α inhibitors compared to conventional treatment (B = 0.825 vs. B = 0.250).
CONCLUSIONS: In this observational cohort of established AS patients, there was no difference in baseline NSAID use between patients with and without indication for TNF-α inhibitors. NSAID use decreased significantly after starting TNF-α inhibitors. During conventional treatment, NSAID use remained stable at group level. However, NSAID use changed frequently at individual patient level and was significantly associated with disease activity.
|Number of pages||12|
|Publication status||Published - 24-Apr-2018|
- NONSTEROIDAL ANTIINFLAMMATORY DRUGS, AXIAL SPONDYLOARTHRITIS, RADIOGRAPHIC PROGRESSION, ASAS RECOMMENDATIONS, ACTIVITY INDEX, DESIR COHORT, TRIAL