Therapeutic controversies in spondyloarthritis: nonsteroidal anti-inflammatory drugs.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered a first-line therapy in patients with axial spondyloarthritis (axSpA), including ankylosing spondylitis. NSAIDs reduce pain and stiffness effectively in most patients, are able to reduce systemic and local inflammation, and can inhibit progression of structural damage in the spine. However, effective control of symptoms and retardation of radiographic progression often require continuous and long-term treatment, which raises safety concerns. This article discusses controversies related to the current role of NSAIDs in axSpA treatment, risks and benefits of this treatment, and current trends for individualized treatment.
Rheumatology, Medical Department I, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin 12203, Germany. denis.poddubnyy@charite.de
Denis
D
Poddubnyy
Désirée
D
van der Heijde
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D010146:Pain / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D057285:Precision Medicine; D018570:Risk Assessment; D025241:Spondylarthritis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents