In all, 296 patients (95%) completed the NSAID washout and had scan 1. After the washout period, 50% of patients (n=135) reported an increase in spine pain at a median of two points on a numerical rating scale of 0–10 (interquartile range: 1–3), and 61% of patients (n=166) had worsening of disease activity, with a median BASDAI increase of 0.9 (interquartile range: 0.5–1.6).
After scan 1, 50% of patients (n=149) had bone marrow edema lesions. Of these patients, 131 (88%) participated in scan 2. Of the 131 patients who completed scan 2, 31 patients had no bone marrow edema lesions (24%; 95% confidence interval: 17–32%).
Conclusion
The study results suggest NSAIDs may affect bone marrow edema when sacroiliitis is also present. When NSAIDs were being taken by patients, an approximate 25% reduction in lesions was found.
Additionally, when NSAIDs are consumed, axSpA diagnosis and classification may be hindered. To determine a more accurate axSpA diagnosis, use of an NSAID washout period may be prudent prior to the MRI imaging, if the patient agrees.
This study is useful in garnering a more accurate diagnosis in this patient population.
Michele B. Kaufman, PharmD, BCGP, is a freelance medical writer based in New York City and a pharmacist at New York Presbyterian Lower Manhattan Hospital.
References
- Jones GT, Bennett AN, Sengupta R, et al. Non-steroidal anti-inflammatory drugs reduce sacroiliac joint inflammation in axial spondyloarthritis (abs OA14). Oral presentation, British Society for Rheumatology Annual Conference. 2023 Apr 23.
- Diseases and conditions: Spondyloarthritis. American College of Rheumatology. 2023.
