The Effect of Nonsteroidal Anti-Inflammatory Drugs on the Progression of Sacroiliitis in Patients With Axial Spondyloarthritis
Keywords:
spondyloarthritis, axial spondyloarthritis, ankylosing spondylitis, non-pathogenic axial spondyloarthritis, sacroiliitis, radiological progressionAbstract
The aim of the study was to compare the effect of constant intake of nonsteroidal anti–inflammatory drugs (NSAIDs) and their on-demand administration on the activity and radiological progression of early axial spondyloarthritis (accSpA).
Material and methods. The study included patients from the CORSAIR cohort who met the criteria of the ASAS 2009 ACSPA. The present analysis included 68 patients who were followed up for at least 24 months. The age at the time of inclusion in the study was 28.5±5.8 years, the average duration of the disease was 24.1±15.4 months, 63 (92.6%) patients were positive for HLA–B27. Patients were divided into two groups: in the first (n=35), patients received NSAIDs continuously during the follow–up period at maximum therapeutic doses, in the second (n=33), NSAIDs were prescribed "on demand" depending on the presence and severity of back pain.
Results and discussion. In the first group, after 2 years of follow-up, the median stage of radiological the sacroiliitis score (SI) has not changed and remains equal to 4 points, in the second group this indicator is for the observed period significantly increased from 3 to 4 points (p<0.05). Initially, the patient groups did not differ in the level of C-reactive protein (CRP), ASDAS-CRP and BASFI indices, but the BASDAI index was higher in the first group (p<0.05). The number of patients with active SI according to magnetic resonance imaging (MRI) and the degree of its severity did not significantly differ in both groups. After 2 years, all patients retained low disease activity according to ASDAS-CRP, BASDAI and CRP levels, as well as data the indicators did not differ significantly in both groups, the BASFI index became higher in the first group. The number of patients with active SI decreased according to MRI data, but there were no differences between the groups.
Conclusion. In patients with early accSpA, the constant use of NSAIDs allows to slow down the X-ray progression to a greater extent than the "on-demand" intake.
