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

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…