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42. Kongress der Deutschen Gesellschaft für Rheumatologie, 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 24. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

17.-20. September 2014, Düsseldorf

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Do patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis respond similarly well to NSAIDs? – a prospective study including magnetic resonance imaging

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  • Xenofon Baraliakos - Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne
  • Uta Kiltz - Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne
  • Frank Heldmann - Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne
  • Heiner Appel - Charité - Universitätsmedizin Berlin, Rheumatologie, Berlin
  • Friedrich Dybowski - Rheumapraxis Ruhr, Herne
  • Manfred Igelmann - Praxis, Bochum
  • Ludwig Kalthoff - Internistisch-Rheumatologische Schwerpunktpraxis, Herne
  • Dietmar M. J. Krause - Internistische und rheumatologische Gemeinschaftspraxis, Gladbeck
  • Hans-Jürgen Menne - Praxis, Dortmund
  • Ertan Saracbasi-Zender - Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne
  • Elmar Schmitz-Bortz - Rheumatologische und Osteologische Schwerpunktpraxis Hattingen, Hattingen
  • Jürgen Braun - Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Düsseldorf, 17.-20.09.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocSP.03

doi: 10.3205/14dgrh236, urn:nbn:de:0183-14dgrh2368

Published: September 12, 2014

© 2014 Baraliakos et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Einleitung: After an unsatisfactory response to at least 2 NSAIDs within 4 weeks, anti-TNF agents are considered in axSpA. It is unknown whether patients with nr-axSpA and AS respond similarly well to NSAIDs.

Methoden: Consecutive patients (pts) with axSpA (n=50 nr-axSpA, n=50 AS) were prospectively included if BASDAI was ≥4, had not yet received the maximally approved NSAID dose and had not been treated with anti-TNF yet. The maximal dose of NSAIDs was administered over 1wk and was then adapted in case of BASDAI<4. In case of BASDAI≥4, the NSAID was changed and pt was treated for another 3 wk at the maximal dose. Clinical and laboratory parameters and dosage of drugs were assessed by using the ASAS-NSAID-index. MRIs of the SIJ were performed and scored by the Berlin score. Data were collected before (BL) and after 1 and 4 wk of treatment.

Ergebnisse: Demographic characteristics were similar to known data about nr-axSpA and AS. Prior to treatment, the ASDAS-CRP was >2.1 in 76% and 74% and a positive MRI occurred in 70% and 78% of pts with nr-axSpA and AS, respectively. After wk1 and wk4, both groups showed similarly increased rates in the NSAID-index and also similar responses to NSAIDs, with significant improvement from BL in all assessments with the exception of CRP levels and MRI-a scores, where almost no changes were observed. At wks 1 and 4, an ASAS20% response was found in 40% (21% with nr-axSpA and 19% with AS) and in 52% of pts (23% nr-axSpA and 29% AS), while ASAS partial remission was found in 10% (4% nr-axSpA and 6% AS) and in 16% of pts (7% nr-axSpA and 9% AS), respectively. However, 49% and 44% of all pts still had a BASDAI ≥4 at wks 1 and 4, and similar results were found for an ASDAS-CRP cut-off of ≥2.1, with 37% and 33% achieving this at wks 1 and 4 (no differences between nr-axSpA and AS).

Schlussfolgerung: Patients with nr-axSpA and AS show similar response rates to NSAID treatment. 40-50% of pts with axSpA still showed BASDAI levels >4 after 4wk of intensive NSAID therapy.