title: Use of nonsteroidal anti-inflammatory drugs in early axial spondyloarthritis in daily practice: Data from the DESIR cohort.
abstract: OBJECTIVE
  Nonsteroidal anti-inflammatory drugs (NSAID) are the cornerstone of treatment in axial spondyloarthritis (axSpA). We aimed to describe the real life NSAID use in early axSpA according to the disease characteristics.
  
  
  METHODS
  The DESIR cohort is an observational study of patients presenting with inflammatory back pain suggestive of axSpA for less than 3 years. Patients who attended all 6 visits (every 6 months during the first 2 years and yearly at 3 years) were analysed. Data collected at every visit over 3 years was NSAID intake and the ASAS-NSAID score for the 6 months preceding the visit, where 100 reflects the full daily intake of an NSAID.
  
  
  RESULTS
  In all, 627 patients were assessed: 46.1% males, mean age: 33.7 (standard deviation: 8.7) years, mean symptom duration: 1.5 (0.9) year and mean BASDAI: 44.3 (25.3). Over the 6 months preceding inclusion, 92.8% had received NSAIDs; this proportion significantly decreased over time, to 73% patients after 3 years (P<0.001). This decrease was not different with regard to the fulfillment (or not) of the ASAS criteria at baseline, nor with regard to the "arm" of the ASAS criteria fulfilled (i.e. imaging vs. clinical). The median ASAS-NSAID score was 36 [interquartile range: 13-72] at inclusion, and substantially decreased to reach 7 [0-44] after 3 years (P<0.001), although BASDAI at 3 years was 33.8 (21.7).
  
  
  CONCLUSIONS
  NSAID prescription was very frequent in this early axSpA cohort, but the intake was low, and decreased significantly over time, even though symptoms remained present. Early axSpA patients may not be sufficiently treated with NSAIDs.
authors.affiliation: GRC-UPMC 08 (EEMOIS), department of rheumatology, UPMC Université Paris 06, AP-HP, Pitié-Salpêtrière Hospital, 75013 Paris, France; Rheumatology department, Paris Descartes University, Cochin Hospital, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm (U1153), clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, 75004 Paris, France. Electronic address: anna.molto@aphp.fr.
authors.forename: Anna
authors.initials: A
authors.lastname: Molto
authors.affiliation: UPMC Université Paris 06, department of public health, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Granger
authors.affiliation: Rheumatology department, université de Franche-Comté, CHRU de Besançon, 25030 Besançon, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: Rheumatology department, Paris Descartes University, Cochin Hospital, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm (U1153), clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, 75004 Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: GRC-UPMC 08 (EEMOIS), department of rheumatology, UPMC Université Paris 06, AP-HP, Pitié-Salpêtrière Hospital, 75013 Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects*; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Nonsteroidal anti-inflammatory drugs; Spondyloarthritis