Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group NSAIDs

I keep reading in a lot of posts here not to use NSAIDs because they will make the AS worse. Could someone please provide me with some references in literature where this advice is recommended? I would appreciate some recognized sources such as the journal of rheumatology, etc., not wikipedia or some such source. I would like to be able to make an educated decision as to their use. Thanks.

I have never seen a study on that merlin. I am not pro nsaid just because of the known gut abuse. ON the other hand all the dmards also have a risk. MTX can be as hard on the stomach as a nsaid for example.

I am off nsaids and we hope my son does not use them for over 3 - 4 months as we work on another solution.

I do think if you feel you have to take a nsaid use a ppi with it from day one to minimize the risk to the gut. There are several nsaids that are less toxic to the gut. Do research on Etodolac, and Relefen. Relefen seems to rarely give ulcers and is metabolized by the body differently. Etodolac is a bit like celebrex in that it is more cox2 selective than most nsaids. It has a pretty good safety profile but can still cause the stomach problems.

Best of luck

Steve

Hi there. If I come across anything I will let you know. I'm no drug expert but I'd be very very surprised if it were true that NSAIDS actually make AS worse. I think the facts are certainly that NSAIDS mask the problem i.e they deal with the symptoms and not the cause...and of course, they can create added problems such as ulceration etc.
cheers
Don

I have never heard of that either..

I know for me I dont take Nsaids anymore because none of them worked for me but many people here are on them that they do help.

Lisa

Lisa,
I'm curious. Did the NSAIDS never work for you, or are they only not working right now?

I'm asking because NSAIDS don't do anything for me. The rheumy said that indicates that my problem might not be AS.

Karen

I have been taking Voltaren for almost 2 years. Twice, during that time, I have stopped taking them because I thought I was feeling better and maybe they were not a part of that. I am also on Humira. After 1 month, I was in so much pain again I couldn't function. So, I started back on the NSAID and, after another whole month, I was back to feeling "pretty good".

I take Nexium as a tummy protector, but naturally wish I didn't need the Voltaren. I just can't understand why the Humira isn't enough, but the combination seems to work best for me.

Good luck,
Jessie

The reason I ask isn't because they don't work for me--they do. However, some people on this forum vehemently oppose using NSAIDs stating that they cause progression of AS. I would just like to see some reputable articles stating one way or the other on the issue of NSAID use. I've been on them for years and take Protonix with Voltaren. I am just interested in knowing the truth rather than going on anyone's opinion.

merlin, aloha

perhaps, try to answer yor question...but i have no citations for you.
forty years of experience though.

first off...not everyone respond to Nsaids, sometimes it's a question of which one you try amongst all the choices
and it takes severl tries to find the 'right one'...and secondly, many older rheumy's were taught in rheumy school
that 'positive response to Nsaids' was one of the diagnostic criteria for AS...it's the same genera as those who believe:
'women don't get AS , and you may go into remission.' old school/bad advice/ not true.

many people with 'serious' AS simply have reached a point where Nsaids just don't do anything at all.

no one in the 'modern' med world should be taking something like Voltaren with also taking a ppi tummy protector.

One big problem with Nsaids is they can kill you...in the US in 2002 16,000 people died from Nsaid induced ulcers;
in 2006 it was 6,000. the billion dollar ppi tummy protector industry is a part of those numbers. {we all forget in
chastising the FDA's approval of vioxx that there was a DESPERATE medical need for Nsaid 'easy on the tummy'

if, perchance you go o the ER with a tummy problem ever, about the third question they ask is ' do Nsaids?'

now...non tech, as explained in civilian terms...Nsaids are very hard first off on the liver, which is why your rheumy
will pester you about blood tests if he's on the ball...and Nsaids are very ROUGH on the digestive system...and
Nsaids partly work by thinning the blood which inhibits the body form repairing little puckers and bubbles and
sores in the digestive system.......[so's you don't heal upthe little injuries the Nsaids create}
in tech terms there are eight or nine different specific diagnostic codes from gerd to internal hemmorage
all associated with Nsaids...it takes about $ 20,000 in medical tests to pick the specific one, if ya need to keep score...

john will point out that you can't have AS without tummy problems first; i don't buy this personally, but I
can guarantee you will have tummy problems in the end in a life fueled by Nsaids.

when i started Tolmetin back in 74, my doctor gave me the remission talk...take these for six weeks and
you'll find the disease activity shut down, may just turn it off... ah, the tuff part was two months later when
all the pain and stuff came back with a vengence.

i was almost one of 2002's statistics, not fun...now i do enbrel, it works, Nsaid free for two plus years...
still on tummy protector, prevacid, will be till i'm off Nsaids for five years...maybe evelyn can provide lit links.
good luck
aB

and Nsaids don't stop the action of the spondy monster; they just mask the symptoms so you stop complaining

Nobody on this forum wants to bother answering your inquiries because they don't want to get another "administrative warning" against so called "flaming."

[edit]

Now if you or the company that manufacturers or distributes your pharmaceuticals are letting the dregs get into the manufactured food chain and it ends up killing wildlife or even pets due to kidney failure, perhaps... [edit].

Each proscribed pharmaceutical drug agent I've seen comes with a very detailed, technical list of possible harmful side effects based on years of trials of study and keeping track of the reactions of patients once in use. I would suggest you start by reading those and then expand your inquiry by using PubMed and the Merck manual. PubMed may be found by using the search engine "Google."

There are college courses on scientific/medical terminology and basic statistics... [edit]

PS. I've had more than one Licensed Medical Professional Physician tell me as a patient not to take certain pharmaceutical concoctions daily because it would cause me damage. Their opinion, based on their training and experience, supercedes anyone else's.
It is nice to see so much back- up on the internet, however.
Paging Dr. Mercola.
Paging Dr. Erbringer
PSS. It took a year before an optician (of all people!) finally pinpointed the bizarre neuro symptoms I was having were probably caused by... acid blockers. And then when I stopped them, it mercifully went away. That's probably not in too many textbooks, but I'm certainly happy that he was up on it based on his studies and patient observations.

I've also been bear- baited by enough [edit] to normally try to avoid [some people] unless it gets to the point of harassment, which I feel this is, esp. when we have people here on this forum truly suffering some ghastly side effects from NSAIDS and pleading for alternatives so they don't .... throw up, suffer intense pain from acid reflux, suffer esophagus damage from reflux, have continuous gut pain so they cannot function, have side effects from malnutrition due to gut damage, die from internal bleeding or suffer prolonged kidney and/or liver damage. My (slight) sense compassion insists that I continue to remind the world at large that the treatments can be even worst than the disease. If that's offensive, life's too short to be spending so much time on the internet.

But whatever you do, DON'T ask for internet references here on this site for pharmacological information because as you've already stated, it's all wrong, all the time, scientifically unverifiable and probably borderline un patriotic and un American, perhaps borderline un Canadian and definitely would be banned in China.

In fact, you didn't read this here.

wow you actually were on nsaids from 74 - 02? that is a very long time.