Department of Internal medicine, Division of rheumatology, Izmir Katip Celebi University Faculty of Medicine.
ARP Rheumatol. 2023 Oct-Dec;2(4):322-329.
To evaluate non-steroidal anti-inflammatory drug (NSAID) use and Assessment in Spondyloarthritis International Society (ASAS)-NSAID scores in patients with axial spondyloarhritis (axSpA) in a longitudinal study.
In total, 429 patients with axSpA (59% male; 63.6% with AS) were included in this study. Data about disease activity, C-reactive protein (CRP) levels, and NSAID use and dosage were collected at 0, 12, 24, and 52 weeks retrospectively. The relationship with NSAID use /ASAS-NSAID scores and other factors were tested using generalized estimating equations (GEE).
At baseline (0 weeks), 92.8% of patients in biologic disease-modifying anti-rheumatic drugs (bDMARDs) group and 82.1% of patients in conventional treatment group were treated with NSAIDs. At baseline, the proportion (p=0.03) and the median (IQR) ASAS-NSAID scores were higher in bDMARDs group [100 (50) vs 50 (83.4); p<0.001]. During follow-up, NSAID use and ASAS-NSAID scores decreased significantly in patients treated with bDMARDs (p<0.001) and the reduction remained stable throughout the follow-up However, neither NSAID use (p=0.06) nor ASAS-NSAID scores changed in conventional treatment group (p=0.15). In bDMARD-treated patients, ASDAS-CRP and BASFI scores were independent determinants for NSAID use, and BASDAI and PGA were determinants for NSAID dosage. There was no independent significant predictor for ASAS-NSAID scores; PGA was the only significant predictor for NSAID use in the conventional treatment group.
Concurrent biologic treatment was associated with low NSAID intake in patients with axSpA, and NSAID use was determined mainly by disease activity and partly by function during bDMARD treatment.
在一项纵向研究中，评估患有中轴型脊柱关节炎（axSpA）患者的非甾体抗炎药（NSAID）使用情况和评估脊柱关节炎国际学会（ASAS）-NSAID 评分。
共纳入 429 例 axSpA 患者（59%为男性；63.6%为 AS）。回顾性收集疾病活动度、C 反应蛋白（CRP）水平以及 NSAID 使用和剂量的数据，分别在 0、12、24 和 52 周时进行。使用广义估计方程（GEE）测试 NSAID 使用/ASAS-NSAID 评分与其他因素之间的关系。
在基线（0 周）时，生物改善病情抗风湿药（bDMARD）组中 92.8%的患者和常规治疗组中 82.1%的患者接受 NSAID 治疗。基线时，bDMARD 组的 NSAID 使用比例（p=0.03）和 ASAS-NSAID 评分中位数（IQR）更高[100（50）比 50（83.4）；p＜0.001]。在随访期间，bDMARD 治疗患者的 NSAID 使用和 ASAS-NSAID 评分显著下降（p＜0.001），且这种下降在整个随访期间保持稳定。然而，常规治疗组的 NSAID 使用（p=0.06）或 ASAS-NSAID 评分均无变化（p=0.15）。在接受 bDMARD 治疗的患者中，ASDAS-CRP 和 BASFI 评分是 NSAID 使用的独立决定因素，BASDAI 和 PGA 是 NSAID 剂量的决定因素。ASAS-NSAID 评分无独立的显著预测因素；PGA 是常规治疗组 NSAID 使用的唯一显著预测因素。
在 axSpA 患者中，联合使用生物制剂与 NSAID 低剂量相关，并且 NSAID 的使用主要取决于疾病活动度，部分取决于 bDMARD 治疗期间的功能。
