Continuous vs. As-Needed Nonsteroidal Anti-Inflammatory Drug Therapy in Patients with Ankylosing Spondylitis

In a small trial, spinal radiographic progression did not differ significantly between groups.

Some evidence suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit ossification in patients with ankylosing spondylitis (AS). To determine whether continuous NSAID therapy slows radiographic progression in AS, researchers in Germany randomized 167 AS patients (mean age, 43; 71% men) to receive either continuous diclofenac (75–150 mg daily) or diclofenac as needed for 2 years. Anti–tumor necrosis factor therapy was not allowed before or during the trial. Spinal x-rays were performed at baseline and at 2 years; NSAID intake was assessed at baseline and every 12 weeks thereafter.

About 75% of each group completed the study; on average, patients in the as-needed group took about 60% as much diclofenac as continuously treated patie…

Reviewing Author

Jonathan S. Coblyn, MD

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Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Continuous vs. As-Needed Nonsteroidal Anti-Inflammatory Drug Therapy in Patients with Ankylosing Spondylitis

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Reviewing Author