Ankylosing spondylitis and symptom-modifying vs disease-modifying therapy

Akkoc N., van der Linden S., Khan M. A.

BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY, vol.20, no.3, pp.539-557, 2006 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 3
  • Publication Date: 2006
  • Doi Number: 10.1016/j.berh.2006.03.003
  • Journal Name: BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.539-557
  • Keywords: ankylosing spondylitis, management, treatment, drug therapy, NSAIDS, DMARDS, corticosteroids, disease modification, adverse effects., NONSTEROIDAL ANTIINFLAMMATORY DRUGS, OPEN-LABEL TRIAL, INTRAARTICULAR CORTICOSTEROID INJECTION, METHYLPREDNISOLONE PULSE THERAPY, RANDOMIZED CONTROLLED-TRIALS, ACUTE MYOCARDIAL-INFARCTION, DOUBLE-BLIND, SACROILIAC JOINTS, RHEUMATOID-ARTHRITIS, CLINICAL-TRIAL
  • Dokuz Eylül University Affiliated: No

Abstract

The main objectives of medical therapy in ankylosing spondylitis; (AS) are to relieve pain, stiffness and fatigue and to prevent structural damage. The Assessment in Ankylosing Spondylitis Working Group has proposed different domains with specific instruments to assess the efficacy of therapeutic agents classified as symptom-modifying and disease-controlling antirheumatic drugs. Non-steroidal anti inflammatory drugs (NSAIDs) are still the first-line treatment in the management of AS, and they are effective in controlling symptoms such as pain and stiffness and maintaining mobility in many patients. A recent randomized trial suggested that the progression of radiological damage occurs less on continuous use of celecoxib compared with on-demand use. If such findings were confirmed by other studies, the therapeutic value of NSAIDs in AS may extend beyond symptom control. However, for each individual patient, the expected advantages of treatment with NSAlDs; should be weighted against any possible gastrointestinal and cardiovascular disadvantages.