Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Are NSAIDs disease-modifying antirheumatic drugs?

http://ard.bmj.com/content/early/2012/08/02/annrheumdis-2012-201844.full

Ann Rheum Dis doi:10.1136/annrheumdis-2012-201844
Editorial
NSAIDs and radiographic progression in ankylosing spondylitis Bagging big game with small arms?
Nigil Haroon1, Tae-Hwan Kim2, Robert D Inman1
+ Author Affiliations

1Department of Rheumatology, Toronto Western Hospital, University of Toronto, Toronto, Canada
2Hospital for Rheumatic Diseases, Hanyang University, Seoul, Republic of Korea
Correspondence to
Professor Robert D Inman, 1E-423, 399 Bathurst Street, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada; Robert.Inman@uhn.ca
Are NSAIDs disease-modifying antirheumatic drugs (DMARDS)?

(snip)..."Non-steroidal anti-inflammatory drugs (NSAIDs), including Coxibs, are recommended as first-line drug treatment for patients with ankylosing spondylitis (AS) with inflammatory back pain and stiffness. Continuous treatment with NSAIDs is preferred for patients with persistently active, symptomatic disease.1

Although many young patients with AS may be at lower risk of gastrointestinal and cardiac adverse events with NSAID therapy than older patients with other rheumatic diseases, patients and physicians alike continue to raise questions about the optimal role of these agents in AS. (more...)

Interesting question. I'm not sure that I understand what "disease-modifying" is in RA though, so not sure what the result of disease modifying would be expected to be in AS. Is it decreasing inflammation? or decreasing risk of anyklosing/fusion? or reducing some other precursor to fusing?

Decreasing inflammation and therefor decreasing risk of ankylosing/fusion.

The full paper is freely available - long! (Have only glanced at it).

Hi, Molly:

My answer is YES: NSAIDs make this disease much worse, so they do in fact 'modify' disease progression and outcome.

All these particular researchers can prove is that NSAIDs increase damage (because they never use honest control groups).

HEALTH,
John

Know that NSAIDs did a right number on me. Refuse to touch em ever again.

Makes one annoyed that they are still so insistent on pushing the NSAIDs. Setting aside the actual harm that they do to so many patients. Not just those with AS or arthritic conditions. A chum of mine unable to stomach NSAIDs after being put on them when she suffered a nasty accident and damaged her spine. But doctors just seem unable to take on board that we don't all have guts of steel...! Will 'keep' stuffing the drugs at one.

My answer is they help me .had 23 disc fused at start.age 21 now 56 still taking indocin 2x a day.This AS afects every one different and so do the meds.
Bradford

That is the point I made 'we don't all have guts of steel' - and indeed, we will all react differently to many drugs. What really gets my goat is when one tells the doctor that one can't tolerate and their reaction is to claim that one is non-compliant and refusing. Sure I 'refuse' but only with very *good reason. And then they still 'insistant' on one taking the meds/drugs. Maddening.

Hi

I took phenylbutazone daily for twenty-five years, and it helped me greatly. I am not fused hardly at all. The only reason I don't take them, is because they are no longer being made. I then went to Voltaren, and it killed my stomach and not any improovemnt. I noticed the study was done about phenylbutazone. I would glady take it if still available. We are all different, and have different outcomes in my opinion.


Janet