Nonsteroidal antiinflammatory drugs (NSAIDs) are the first-line pharmacotherapy for patients with axial spondyloarthritis (SpA). In recent years, treatment options have expanded with the availability of biologic agents, including tumor necrosis factor inhibitors and interleukin-17 inhibitors. However, a treatment strategy that clearly prevents syndesmophyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease-modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently available medications for axial SpA have an effect on spine radiographic progression, beyond symptom control, remains inconclusive. In this article, we will review clinical studies of the disease modification effects of NSAIDs and biologics in axial SpA; examine genetic, animal, and clinical evidence of the effects of NSAIDs on bone formation; and discuss how future studies may investigate the question of disease modification in axial SpA.

中文翻译：

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非甾体类抗炎药作为中轴型脊柱关节炎的潜在疾病缓解药物。


非甾体抗炎药 (NSAID) 是中轴型脊柱关节炎 (SpA) 患者的一线药物治疗。近年来，随着生物制剂（包括肿瘤坏死因子抑制剂和白细胞介素 17 抑制剂）的出现，治疗选择不断扩大。然而，尚未建立明确预防韧带骨赘形成的治疗策略。对强直性脊柱炎患者的观察性研究表明非甾体抗炎药具有潜在的疾病缓解作用，但两项随机试验得出了不同的结论。更广泛地说，目前任何一种治疗中轴型 SpA 的药物是否对脊柱影像学进展（超出症状控制范围）有影响，仍无定论。在本文中，我们将回顾 NSAID 和生物制剂对中轴型 SpA 疾病缓解作用的临床研究；检查非甾体抗炎药对骨形成影响的遗传、动物和临床证据；并讨论未来的研究如何调查中轴型 SpA 的疾病缓解问题。