Table 1.
Studies of the association between treatment with tumor necrosis factor-alpha inhibitors (TNFi) and nonsteroidal anti-inflammatory drugs (NSAIDs) and progression of radiographic spinal damage in ankylosing spondylitis by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS)
| Reference | Treatment | Comparison | Number in treated group |
Number in comparison group |
Duration of follow-up |
Mean (± SD) change in mSASSS in treated group |
Mean (± SD) change in mSASSS in comparison group |
P | Odds of progression (OR, 95% CI) |
Proportion (%) with progression in treated group |
Proportion (%) with progression in comparison group |
Definition of progression (Increase in mSASSS units) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Open-label extensions of controlled trials of TNFi | ||||||||||||
| 16 | Etanercept | TNFi naïve Historical |
257 | 175 | Up to 2 years | 0.91 ± 2.4 | 0.95 ± 3.2 | 1.00 | - | - | - | - |
| 17 | Infliximab | TNFi naïve Historical |
156 | 192 | Up to 2 years | 0.9 ± 2.6 | 1.0 ± 3.2 | 0.55 | - | 19.9 | 17.6 | ≥ 2 |
| 18 | Adalimumab | TNFi naïve Historical |
307 | 169 | Up to 2 years | 0.8 ± 2.6 | 0.9 ± 3.3 | 0.78 | - | - | - | - |
| 19 | Golimumab | None | 299 | - | Up to 4 years | - | - | - | - | 27.8 | - | > 2 |
| Observational studies of TNFi | ||||||||||||
| 20 | Infliximab | TNFi naïve Historical |
22 | 34 | 8 years | 0.9 ± 0.8* | 1.5 ± 1.4* | 0.13 | - | - | - | - |
| 21 | Any TNFi | TNFi non-users |
201 | 133 | Up to 6.3 years | - | - | - | 0.52 (0.30 – 0.88) | 27 | 35 | ≥ 1* |
| Randomized clinical trial of NSAIDs | ||||||||||||
| 22 | Celecoxib daily |
Celecoxib as needed |
76 | 74 | 2 years | 0.4 ± 1.7 | 1.5 ± 2.5 | 0.002 | - | 11 | 23 | ≥ 3 |
| Observational study of NSAIDs | ||||||||||||
| 23 | NSAIDs High intensive |
NSAIDs Low intensive |
64 | 24 | 2 years | - | - | - | 0.15 (0.02 – 0.96) | 8.3 | 21.9 | ≥ 2 |
*
Change per year