AS Treatment: NSAID

Efficacy of long-term nonsteroidal antiinflammatory drug treatment on magnetic resonance imaging-determined bone marrow oedema in early, active axial spondyloarthritis patients

To assess the efficacy of long-term treatment with nonsteroidal antiinflammatory drugs (NSAIDs) on bone marrow oedema (BMO) of the sacroiliac joint in newly diagnosed axial spondyloarthritis (SpA) wit

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Continuous full-dose NSAID treatment for 6-12 months in relatively early AS (less then 4 years from symptom onset) can help ameliorate radiological inflammation (bone marrow oedema) as well as clinical disease activity.

Limited Efficacy of NSAIDs in Spondyloarthritis

Prior to the biologic era, nonsteroidal antiinflammatory drugs (NSAIDs) were the mainstay of drug therapy in thos with spondyloarthritis (SpA) and ankylosing…

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However, NSAID’s efficacy in reducing AS inflammation is severely limited by patients’ poor tolerance and compliance with daily full dose treatment. A mere month of treatment is not going to do anything for bone marrow oedema or even acute phase reactants like the CRP.
In older individuals with metabolic comorbidities, the cardiovascular risk with any NSAID usage is even more unacceptable.