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Ankylosing spondylitis disease activity score is related to NSAID use, especially in patients treated with TNF-? inhibitors.


ABSTRACT: 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-? inhibitors) in daily clinical practice.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-? 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-? inhibitors compared to conventional treatment (B = 0.825 vs. B = 0.250).In this observational cohort of established AS patients, there was no difference in baseline NSAID use between patients with and without indication for TNF-? inhibitors. NSAID use decreased significantly after starting TNF-? 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.

SUBMITTER: Carbo MJG 

PROVIDER: S-EPMC5915774 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Ankylosing spondylitis disease activity score is related to NSAID use, especially in patients treated with TNF-α inhibitors.

Carbo Marlies J G MJG   Spoorenberg Anneke A   Maas Fiona F   Brouwer Elisabeth E   Bos Reinhard R   Bootsma Hendrika H   van der Veer Eveline E   Wink Freke F   Arends Suzanne S  

PloS one 20180424 4


<h4>Background</h4>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.<h4>Methods and findings</h4>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  ...[more]

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