Comparative efficacy of non-steroidal anti-inflammatory drugs in ankylosing spondylitis: a Bayesian network meta-analysis of clinical trials

  title={Comparative efficacy of non-steroidal anti-inflammatory drugs in ankylosing spondylitis: a Bayesian network meta-analysis of clinical trials},
  author={Runsheng Wang and Abhijit Dasgupta and Michael M. Ward},
  journal={Annals of the Rheumatic Diseases},
  pages={1152 - 1160}
OBJECTIVE To compare the efficacy of 20 non-steroidal anti-inflammatory drugs (NSAIDs) in the short-term treatment of ankylosing spondylitis (AS. [] Key Method We included trials that reported efficacy at 2-12 weeks. Efficacy outcomes were the change in pain score and change in the duration of morning stiffness. We also examined the number of adverse events. We used Bayesian network meta-analysis to compare effects directly and indirectly between drugs. RESULTS We included 26 trials (66 treatment arms…

Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta-analysis of randomized, double-blinded, controlled trials

All NSAIDs were significantly more effective in reducing pain severity than placebo and etoricoxib was ranked as the most efficacious treatment for patients with AS, however, clinicians should take GI toxicity into account when prescribing NSAIDs.

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

New evidence on the management of spondyloarthritis

Data indicate that TNF blockers are effective for treating peripheral arthritis, enthesitis and dactylitis, the typical manifestations of peripheral SpA, and the potential of IL-23 blockade for treatment of axial SpA needs to be further investigated.

Ankylosing spondylitis disease activity score is related to NSAID use, especially in patients treated with TNF-α inhibitors

In this observational cohort of established AS patients, there was no difference in baseline NSAIDs use between patients with and without indication for TNF-α inhibitors, but NSAID use changed frequently at individual patient level and was significantly associated with disease activity.

Association between clinical characteristics and pain relief in patients with axial spondyloarthritis treated with non-steroidal anti-inflammatory drugs

Pain relief is still insufficient in some axSpA patients, despite the administration of NSAIDs, and the presence of NP is significantly associated with poor pain relief.

Effects of nonsteroidal anti-inflammatory drugs on serum proinflammatory cytokines in the treatment of ankylosing spondylitis.

NSAIDs could promote the clinical efficacy of treatment for ankylosing spondylitis by regulating serum levels of proinflammatory cytokines by regulating the levels of IL-6 and TNF-α.

Emerging drugs for the treatment of axial spondyloarthritis

The treatment of axial spondyloarthritis has been for nearly 15 years constricted to non-steroidal antirheumatic drugs and TNFα inhibitors but with the approval of secukinumab, a drug targeting the interleukin(IL)-17 axis became available.

Evaluation of the e ffi cacy and safety of β-D-mannuronic acid in patients with ankylosing spondylitis : A 12-week randomized , placebo-controlled , phase I / II clinical trial

In comparison with patients receiving placebo over the 12-week treatment period, those receiving β-D-mannuronic acid and naproxen demonstrated statistically significantly greater improvement in all secondary endpoints and, therefore, suggest that β- D-mannuonic acid is suitable for the management of AS.



Nonsteroidal anti-inflammatory drug use in ankylosing spondylitis—a population-based survey

It is concluded that NSAIDs are effective in the management of inflammatory symptoms of many, but not all, patients with AS, and anti-tumor necrosis factor therapy may reduce the need for intensive long-term NSAID therapy in AS.

Ankylosing spondylitis: what is the optimum duration of a clinical study? A one year versus a 6 weeks non-steroidal anti-inflammatory drug trial.

This study suggests that a 1 yr trial might be of optimum value compared to a 6 week assessment in order to define better the efficacy and tolerability of NSAIDs in ankylosing spondylitis.

Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug.

The results of this study confirm the clinically relevant antiinflammatory effect of celecoxib at a 200-mg daily dosage, with significant improvement of both pain and function in patients with AS.

Evaluation of the efficacy of etoricoxib in ankylosing spondylitis: results of a fifty-two-week, randomized, controlled study.

Etoricoxib at doses of 90 mg and 120 mg demonstrated superior efficacy compared with placebo over 6 weeks, and compared with naproxen over 1 year, demonstrating that etoricoxIB is generally safe, well-tolerated, and efficacious for the treatment of AS.

The efficacy and tolerability of aceclofenac in the treatment of patients with ankylosing spondylitis: a multicenter controlled clinical trial. Aceclofenac Indomethacin Study Group.

Acecl ofenac and indomethacin did not differ with respect to efficacy in the treatment of active AS, although aceclofenac was slightly better tolerated.

A comparative study of Butacote and Naprosyn in ankylosing spondylitis.

A double-blind, cross-over comparison of Naprosyn (naproxen) 750 mg daily and Butacote (enteric-coated phenylbutazone) 300 mg daily was carried out in a multi-centre trial, finding that both drugs significantly reduced morning stiffness.

Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs.

Ankylosing spondylitis is a chronic inflammatory disease with a prevalence of 0.1–1.2%, and the therapeutic options are limited and confined to nonsteroidal antiinflammatory drugs (NSAIDs) and, if this treatment fails, to tumor necrosis factor (TNF) blockers.

A comparison of diflunisal and phenylbutazone in the treatment of ankylosing spondylitis

Diflunisal is an alternative capable of improving the painful stiffness associated with AS and, taking into account the possible haematological side effects, the use of other NSAIDs is stressed.

A double-blind crossover study comparing tolmetin sodium and naproxen in the treatment of ankylosing spondylitis

Pain and stiffness improved on active treatments when compared to placebo, nocturnal pain and immobility stiffness significantly so, and spinal mobility also improved; the decrease in occiput-wall distance was statistically significant for tolmetin sodium whenCompared to both naproxen and placebo.