title: Etoricoxib  and the treatment of ankylosing spondylitis.
abstract: BACKGROUND
  Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapies in the management of patients with ankylosing spondylitis. This chronic inflammatory skeletal disorder, a subtype of spondyloarthritis, is characterized by inflammatory back pain and affects young adults causing important suffering and disability. Long-term use of conventional NSAIDs is associated with a risk of gastrointestinal complications. Etoricoxib is a specific cyclooxygenase 2 inhibitor with strong anti-inflammatory effects and a favorable pharmacokinetic profile for the management of inflammatory disorders. The drug has been associated with reduced severe gastrointestinal adverse events. However, the cardiovascular safety of cyclooxygenase 2 inhibitors has been debated.
  
  
  METHODS
  This review discusses etoricoxib in the treatment of ankylosing spondylitis. Literature searches were performed in PubMed, Web of Science, and the Cochrane library based on the terms "etoricoxib" and "ankylosing spondylitis" or "spondyloarthritis" as well as "safety" and "side-effects."
  
  
  CONCLUSIONS
  Etoricoxib is useful in the first-line management of ankylosing spondylitis patients. Its anti-inflammatory effects and relative protection against severe gastrointestinal side effects should be balanced with negative effects on the cardiovascular system and an overall subjective tolerance not better than that of conventional NSAIDs. Whether etoricoxib will also become a mainstay in the prevention of structural damage in ankylosing spondylitis is not yet clear.
authors.affiliation: University Hospitals Leuven, Division of Rheumatology, Department of Development and Regeneration, Laboratory of Tissue Homeostasis and Disease, Herestraat 49, B3000 Leuven, Belgium. Rik.Lories@uz.kuleuven.be
authors.forename: Rik J
authors.initials: RJ
authors.lastname: Lories
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002908:Chronic Disease; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D004353:Drug Evaluation, Preclinical; D000077613:Etoricoxib; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology; D006207:Half-Life; D006801:Humans; D010146:Pain / Q000188:drug therapy; D011725:Pyridines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D013450:Sulfones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D011725:Pyridines; D013450:Sulfones; D000077613:Etoricoxib