Edited by Archita Rai
Medscape Medical News UK
This study was led by Murat Torgutalp, MD, MSc, Charité – Universitätsmedizin Berlin in Berlin, Germany. It was published online on November 27, 2025, in Arthritis & Rheumatology.
TOPLINE:
In patients with axial spondyloarthritis (axSpA), a higher intake of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with reduced radiographic spinal progression, particularly in those with radiographic disease.
METHODOLOGY:
- Researchers investigated whether the intake of NSAIDs affected the radiographic spinal progression in patients with axSpA, using data from a German cohort.
- They included 252 patients with axSpA (139 with non-radiographic and 113 with radiographic disease; mean age, 35.9 years; 50% men). All patients had at least two consecutive spinal radiographs.
- NSAID intake, stratified by drug type, was assessed over a 10-year follow-up period and scored between 0 and 100, with 0 representing no use and 100 representing full-dose daily use.
- The outcome was an increase in the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) assessed on spinal radiographs over an interval of 2 years.
TAKEAWAY:
- At baseline, 80% of patients were taking NSAIDs, with 18% taking COX-2 inhibitors and 62% taking non-selective NSAIDs. The mean total NSAID intake score was 38.3 points.
- Each 10-point increase in the NSAID intake score was associated with a smaller increase in the mSASSS (adjusted beta coefficient, -0.052; 95% CI, -0.097 to -0.007), consistent across models.
- The effect was evident in patients with radiographic axSpA (adjusted beta coefficient, -0.077; 95% CI, -0.152 to -0.003) but not in those with non-radiographic axSpA.
- Among all patients, a slightly larger reduction in score progression was seen with COX‑2 inhibitors than with non‑selective NSAIDs (adjusted beta coefficient, -0.061 vs -0.045 per 10‑point higher intake), but the difference was not statistically significant.
IN PRACTICE:
“Although NSAIDs are currently recommended as the first-line therapy to manage axSpA symptoms, their potential effect on slowing structural damage may add another dimension to their therapeutic value,” the authors of this study wrote.