Timely treatment of GI symptoms leads to effective management of AS patients on NSAIDs

Timely therapeutic strategies appear to effectively manage gastrointestinal (GI) risk in ankylosing spondylitis (AS) patients undergoing treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), as shown in a recent study.

The analysis involved 591 AS patients (mean age, 38.9 years; 82.1 percent male) treated with NSAIDs for at least 2 weeks. Researchers estimated GI risk using Standardized Calculator of Risk for Events (SCORE) and determined NSAID adherence using Morisky Medication Adherence Scale‐8 (MMAS‐8). Other outcomes investigated were disease activity and quality of life (QoL), assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and EuroQol‐3L (EQ‐5D, EQ‐visual analogue scale [EQ‐VAS]), respectively.

In the cohort, 196 patients (33.2 percent) reported a history of GI symptoms during NSAID treatment, and 64 of them (34.2 percent) had ongoing GI symptoms at baseline.

GI risk, according to the SCORE criteria, was moderate to very high in 37.1 percent of patients. None of the patients showed high adherence to NSAIDs, as shown by the MMAS‐8 scores. As a result, the 326 patients (55.3 percent) with moderate adherence were categorized as adherent and included for further analysis.

Mean BASDAI score was 3.5, and about 40 percent of the population showed suboptimal disease control. Mean QoL scores were 0.6 on EQ‐5D and 67.4 on EQ‐VAS. Path analyses revealed higher GI risk to be associated with significantly reduced QoL.

In light of the present data, GI risk should be monitored and considered as one of the key factors in improving QoL in AS patients on NSAIDs, the researchers said.