Ankylosing spondylitis medical therapy: Difference between revisions
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* Preferred regimen (1): Indomethacin: Initial: 75 mg once daily, may increase to 75 mg twice daily (maximum dose: 150 mg/day).<ref name="pmid1974927">{{cite journal |vauthors=Calin A, Elswood J |title=A prospective nationwide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis |journal=J. Rheumatol. |volume=17 |issue=6 |pages=801–3 |date=June 1990 |pmid=1974927 |doi= |url=}}</ref> | * Preferred regimen (1): Indomethacin: Initial: 75 mg once daily, may increase to 75 mg twice daily (maximum dose: 150 mg/day).<ref name="pmid1974927">{{cite journal |vauthors=Calin A, Elswood J |title=A prospective nationwide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis |journal=J. Rheumatol. |volume=17 |issue=6 |pages=801–3 |date=June 1990 |pmid=1974927 |doi= |url=}}</ref> | ||
* Preferred regimen (2): Celecoxib or etoricoxib: Oral: 200 mg once daily or 100 mg twice daily.<ref name="pmid15818702">{{cite journal |vauthors=van der Heijde D, Baraf HS, Ramos-Remus C, Calin A, Weaver AL, Schiff M, James M, Markind JE, Reicin AS, Melian A, Dougados M |title=Evaluation of the efficacy of etoricoxib in ankylosing spondylitis: results of a fifty-two-week, randomized, controlled study |journal=Arthritis Rheum. |volume=52 |issue=4 |pages=1205–15 |date=April 2005 |pmid=15818702 |doi=10.1002/art.20985 |url=}}</ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pharmacologic medical therapies for ankylosing spondylitis(AS) include Nonsteroidal anti-inflammatory drugs (NSAIDs), tumor necrosis factor (TNF) blocker, and interleukin 17 (IL-17) inhibitors.Ankylosing spondylitis (AS) is a chronic inflammatory disease which is manifested by back pain and gradually to spinal stiffness.While treating the AS patients the primary goal is to maximize long-term health-related quality of life.
Medical Therapy
- Medical therapy for AS is according to the guidelines proposed by [1][2][3]
- Assessment of SpondyloArthritis international Society (ASAS)
- European League Against Rheumatism (EULAR)
- American College of Rheumatology (ACR)/Spondylitis Association of America (SAA)/Spondyloarthritis Research and Treatment Network (SPARTAN) collaboration
- Pharmacologic medical therapies for ankylosing spondylitis(AS) include Nonsteroidal anti-inflammatory drugs (NSAIDs), tumor necrosis factor (TNF) blocker, analgesics, sulfasalazine,intraarticular injections and interleukin 17 (IL-17) inhibitors.
Nonsteroidal antiinflammatory drugs(NSAIDs)[4][5][6][7]
- The first line treatment for all the patients who are having symptomatic ankylosing spondylitis (AS) are with Nonsteroidal antiinflammatory drugs(NSAIDs).
- 70 to 80 percent patients who are taking NSAIDs report substantial relief of back pain and stiffness.
- Play a crucial role in delaying the progression of ankylosing spondylitis.
- Regardless of which NSAID used, the maximum dose is usually required to manage AS.
Adult
- Preferred regimen (1): Indomethacin: Initial: 75 mg once daily, may increase to 75 mg twice daily (maximum dose: 150 mg/day).[8]
- Preferred regimen (2): Celecoxib or etoricoxib: Oral: 200 mg once daily or 100 mg twice daily.[9]
References
- ↑ Braun J, van den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, Dagfinrud H, Dijkmans B, Dougados M, Emery P, Geher P, Hammoudeh M, Inman RD, Jongkees M, Khan MA, Kiltz U, Kvien T, Leirisalo-Repo M, Maksymowych WP, Olivieri I, Pavelka K, Sieper J, Stanislawska-Biernat E, Wendling D, Ozgocmen S, van Drogen C, van Royen B, van der Heijde D (June 2011). "2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis". Ann. Rheum. Dis. 70 (6): 896–904. doi:10.1136/ard.2011.151027. PMC 3086052. PMID 21540199.
- ↑ Zochling J, van der Heijde D, Burgos-Vargas R, Collantes E, Davis JC, Dijkmans B, Dougados M, Géher P, Inman RD, Khan MA, Kvien TK, Leirisalo-Repo M, Olivieri I, Pavelka K, Sieper J, Stucki G, Sturrock RD, van der Linden S, Wendling D, Böhm H, van Royen BJ, Braun J (April 2006). "ASAS/EULAR recommendations for the management of ankylosing spondylitis". Ann. Rheum. Dis. 65 (4): 442–52. doi:10.1136/ard.2005.041137. PMC 1798102. PMID 16126791.
- ↑ Ward MM, Deodhar A, Akl EA, Lui A, Ermann J, Gensler LS, Smith JA, Borenstein D, Hiratzka J, Weiss PF, Inman RD, Majithia V, Haroon N, Maksymowych WP, Joyce J, Clark BM, Colbert RA, Figgie MP, Hallegua DS, Prete PE, Rosenbaum JT, Stebulis JA, van den Bosch F, Yu DT, Miller AS, Reveille JD, Caplan L (February 2016). "American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis". Arthritis Rheumatol. 68 (2): 282–98. doi:10.1002/art.39298. PMC 5123840. PMID 26401991.
- ↑ Ardoin SP, Sundy JS (May 2006). "Update on nonsteriodal anti-inflammatory drugs". Curr Opin Rheumatol. 18 (3): 221–6. doi:10.1097/01.bor.0000218940.04613.cc. PMID 16582683.
- ↑ Zochling J, van der Heijde D, Dougados M, Braun J (April 2006). "Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis". Ann. Rheum. Dis. 65 (4): 423–32. doi:10.1136/ard.2005.041129. PMC 1798100. PMID 16126792.
- ↑ van den Berg R, Baraliakos X, Braun J, van der Heijde D (August 2012). "First update of the current evidence for the management of ankylosing spondylitis with non-pharmacological treatment and non-biologic drugs: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis". Rheumatology (Oxford). 51 (8): 1388–96. doi:10.1093/rheumatology/kes066. PMID 22513148.
- ↑ Lequesne M (February 1990). "Methodology issues in the evaluation of NSAID in inflammatory rheumatic diseases". J Rheumatol Suppl. 20: 25–8. PMID 2182853.
- ↑ Calin A, Elswood J (June 1990). "A prospective nationwide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis". J. Rheumatol. 17 (6): 801–3. PMID 1974927.
- ↑ van der Heijde D, Baraf HS, Ramos-Remus C, Calin A, Weaver AL, Schiff M, James M, Markind JE, Reicin AS, Melian A, Dougados M (April 2005). "Evaluation of the efficacy of etoricoxib in ankylosing spondylitis: results of a fifty-two-week, randomized, controlled study". Arthritis Rheum. 52 (4): 1205–15. doi:10.1002/art.20985. PMID 15818702.