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    Daily Treatment Slows Ankylosing Spondylitis

    Continuous Use of Anti-Inflammatory Drugs May Be Better Than As-Needed Approach
    WebMD Health News

    June 2, 2005 -- People with a type of arthritis called ankylosing spondylitis may fare better by taking anti-inflammatory drugs on a steady schedule instead of on an as-needed basis.

    So say European researchers in June's issue of Arthritis & Rheumatism. In their two-year study, X-rays showed that the disease progressed more slowly in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) continuously, compared with those who took the drugs when needed.

    Ongoing use of NSAIDs didn't substantially increase side effects. This provides a strong indication that regular use of NSAIDs may slow disease progression, according to Astrid Wanders, MD, of University Hospital in Maastricht, Netherlands.

    Ankylosing spondylitis affects the spine, causing pain and stiffness from the neck to the lower back. The bones of the spine, called vertebrae, may grow or fuse together, resulting in a rigid spine.

    Why NSAIDs?

    NSAIDs have been shown to provide rapid relief of inflammatory back pain and stiffness, as well as improving physical function, say the researchers.

    "NSAIDs are among the most frequently prescribed drugs for [ankylosing spondylitis], but toxic effects on the gastrointestinal tract limit their long-term use," they write.

    Since last fall, NSAIDs have also been at the center of controversy over possible higher heart risks in some patients. This study was conducted in France years before that (1998-2001). Most participants were in their late 30s or early 40s and therefore at low risk of heart problems.

    Continuous vs. As-Needed Treatment

    Wanders and colleagues studied 215 people with ankylosing spondylitis.

    Participants were randomly assigned either to take NSAIDs daily for two years or to take NSAIDs as needed during that time. Doses started with 100 milligrams of Celebrex twice daily; participants could raise that to 200 milligrams twice daily or switch to another NSAID while sticking to the same dose plan.

    The study was funded by Pharmacia. Pfizer, a WebMD sponsor, owns Pharmacia.

    X-rays, symptoms, and side effects were noted at 10 visits.

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