Stop the Pain, Slow the Disease

NSAIDs slow progression of ankylosing spondylitis

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Some drugs treat the symptoms of a disease, while others attack the disease at its core, preventing it from getting worse. A certain type of drug may do both for people with ankylosing spondylitis.

A class of anti-inflammatory pain relievers known as non-steroidal anti-inflammatory drugs (NSAIDs) can slow the progression of ankylosing spondylitis, a painful inflammatory disease that affects the spinal joints.

"Talk to your doctor about NSAIDs for your ankylosing spondylitis."

NSAIDs have been shown to reduce the pain and stiffness of ankylosing spondylitis. On top of relieving symptoms, researchers also believe that NSAIDs may also slow down the progression of the disease.

To test this suspicion, Denis Poddunbnyy, M.D., Ph.D., of Charité Medical University, and colleagues studied the impact of NSAIDs on the progression of ankylosing spondylitis and non-radiographic axial spondyloarthritis - a condition with symptoms like ankylosing spondylitis but without damage visible by X-ray.

NSAIDs are the most commonly used class of drug in the treatment of ankylosing spondylitis. They generally cost between $4 and $300 per month.

For their study, The researchers reviewed cervical and lumbar spine X-rays of 88 ankylosing spondylitis patients and 76 patients with non-radiographic axial spondyloarthritis.

They measured disease progression by looking for structural changes to the spine such as erosions, sclerosis (stiffening), vertebral squaring (when a new bone forms at the corners of spinal vertebrae) and syndesmophytes (bony growths in the ligaments of the spine).

The researchers found that ankylosing spondylitis patients who took high dosages of NSAIDs had a much lower rate of disease progression in the spine, compared to those who took low dosages.

They did not find any differences in disease progression among patients with non-radiographic axial spondyloarthritis.

According to Dr. Poddubnyy, these findings add to the body of evidence that NSAIDs not only reduce pain and stiffness, but also can change the course of disease by slowing the structural changes in the spine of people with ankylosing spondylitis.

In other words, NSAIDs appear to slow the growth of structural changes to the spine that can be seen by X-ray.

"The data indicate also that those patients who are at high risk for radiographic progression (e.g., patients with ankylosing spondylitis who already have syndesmophytes) might especially benefit from the continuous use of NSAIDs," Dr. Poddubnyy explains.

However, he adds, such a treatment should only be used if the patient has a high level of pain and stiffness. Patients and their doctors should work together to assess the potential risks and benefits of NSAID treatment, Dr. Poddubnyy recommends.

This research was presented at the Annual Scientific Meeting of the American College of Rheumatology. As this study has yet to be evaluated by a peer-reviewed journal, the findings should be received with caution.

Reviewed by: 
Review Date: 
January 6, 2012
Last Updated:
January 17, 2012