Clinical Edge

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NSAID Therapy and Axial Spondyloarthropathy

Is it efficacious and well tolerated?

Patients on full dose NSAID therapy had a high level of drop out and in those who tolerated it, there was no clinically relevant decrease in SPARCC scores and low BASDAI50 response. This according to a study of 40 patients with axial spondyloarthropathy (AxSpA) and positive MRI sacroiliac joint (MRI SIJ). Researchers found:

• About one-third of patients with newly diagnosed AxSpA were unable to complete the full dose NSAID schedule.

• Compared to baseline, mean SPARCC scores declined by a mere 1.1 units at week 6.

• Only 30% of patients displayed a minimally clinically important difference of ≥ 2.5 in SPARCC score.

• BASDAI scores showed a mean decrease of 0.6 per 2 weeks of therapy.

• Only 29.4% of patients reached a BASDAI50 response at week 6.

Citation: Varkas G, Jans L, Cypers H, et al. Six-week treatment of axial spondyloarthritis patients with an optimal dose of NSAIDs: early response to treatment in signal intensity on magnetic resonance imaging of the sacroiliac joints. [Published online ahead of print October 16, 2015]. Arthritis Rheumatol. doi: 10/1002/art.39474.