Spondyloarthritis & psoriatic arthritis
The Impact of Nonsteroidal Anti‐Inflammatory Drugs on Radiographic Spinal Progression in Patients With Axial Spondyloarthritis: 10‐Year Results From an Inception Cohort
Authors' conclusion
Our findings suggest a beneficial effect of higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA.
Study context
- Population
- Patients with axial spondyloarthritis (axSpA) from the German Spondyloarthritis Inception Cohort (GESPIC) with at least two sets of spinal radiographsGESPIC
- Participants
- 252 patients
- Exposure
- Per 10-point increase in nonsteroidal anti-inflammatory drug (NSAID) intake score; COX2i vs ns-NSAIDs
- nr-axSpAn = 139
- r-axSpAn = 113
- Outcome
- Progression in mSASSS in two-year intervals, per 10-point increase in NSAID intake score (β-coefficient)
- Follow-up
- Two-year intervals
Methodological detailssequential conditional mean models, generalized estimating equations, adjusted for longitudinal repeated measures of exposure and time-dependent confounders
- Sequential conditional mean models
- Generalized estimating equations
- Adjusted for longitudinal repeated measures of exposure and time-dependent confounders
Main finding
As reported in the abstract
mSASSS progression per 10-point increase in NSAID intake score, all axSpA
β (all axSpA), 95% CI −0.097 to −0.007
−0.052
Observational data: associations, not effects.
Further findings
Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) progression per 10-point increase in NSAID intake score, r-axSpA (subgroup)
- β (r-axSpA), 95% CI −0.152 to −0.003
- −0.077
- Effect most pronounced in r-axSpA
mSASSS progression by NSAID type, all axSpA
- β COX2i
- −0.061
- β ns-NSAIDs
- −0.045
- COX2i slightly lower point estimate than ns-NSAIDs, not statistically significant
NSAID treatment at baseline
- Under NSAID treatment, n (%)
- 201 (80.0%)
- Taking COX2i, n (%)
- 46 (18%)
- Taking ns-NSAIDs, n (%)
- 156 (62%)
- Mean total NSAID intake score ± SD
- 38.3 ± 35.5
Original publication
The Impact of Nonsteroidal Anti‐Inflammatory Drugs on Radiographic Spinal Progression in Patients With Axial Spondyloarthritis: 10‐Year Results From an Inception Cohort. Arthritis Rheumatol. Published 26 January 2026. doi:10.
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