Use of nonsteroidal anti-inflammatory drugs in case of ankylosing spondylitis: Long and persistently!


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Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are extensively used in the treatment of rheumatic diseases to relieve pain and signs of inflammation. However, when treated for ankylosing spondylosis (AS), NSAIDS exert both symptomatic and structure-modifying effects, by slowing down the development of vertebral ankylosis. The effect of these drugs, which underlines the formation of syndesmophytes, may be associated with their anti-inflammatory activity and ability to suppress abnormal bone proliferation. There is convincing evidence to support the capacity of NSAIDs, when long and continuously used, to reduce the rates of X-ray progression of AS. So the continuous use of NSAIDs must be now considered to be a mandatory component of pharmacotherapy for this disease. Their use should be continued even after achieving a marked clinical improvement. At the same time, this situation requires that the development of adverse reactions as structural and functional diseases of the gastrointestinal tract and cardiovascular system be thoroughly controlled in this situation. The danger of these complications determines the need for a physician's attention, obligatory consideration of risk factors, and rational choice of the safest NSAIDs.

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Применение нестероидных противовоспалительных препаратов при анкилозирующем спондилите: долго и упорно!. - Аннотация. Нестероидные противовоспалительные препараты (НПВП) широко используются при лечении ревматических заболеваний для купирования боли и воспаления. Однако при лечении анкилозирующего спондилита (АС) НПВП оказывают не только симптоматическое, но и структурно-модифицирующее действие, замедляя развитие анкилоза позвоночника. Эффект этих лекарств может быть связан с противовоспалительным влиянием и способностью подавлять патологическую пролиферацию кости, лежащую в основе формирования синдесмофитов. Имеются убедительные клинические данные, подтверждающие способность НПВП при длительном непрерывном использовании снижать темпы рентгенологического прогрессирования АС. Поэтому в настоящее время постоянный прием НПВП должен считаться обязательным компонентом фармакотерапии этого заболевания. Использование НПВП целесообразно продолжить даже после достижения выраженного клинического улучшения. В то же время в этой ситуации требуется тщательный контроль развития побочных эффектов в виде нарушений структуры и функций желудочно-кишечного тракта и сердечно-сосудистой системы. Опасность этих осложнений обусловливает необходимость внимания врача, обязательного учета факторов риска и рационального выбора наиболее безопасных НПВП.
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A E Karateev

Email: aekarateev@rambler.ru

Sh F Érdes

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