Why carry out this study?

Non-steroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor inhibitors (TNFi) are the most common therapies used in ankylosing spondylitis (AS); however, their associated long-term effects on cardiovascular risk are unclear.

A systematic review and meta-analysis were conducted to synthesize the evidence regarding the long-term cardiovascular safety of NSAIDs and TNFi in AS.

What was learned from the study?

NSAID users as a whole and users of non-selective NSAIDs did not seem to have a higher risk of any cardiovascular events (CVE).

More data are needed on the risk of Cox-2 inhibitors in AS patients. Limited data suggest lower risk of composite CVE outcome, unlike their use in the general population.

No significant association between TNFi and myocardial infarction (MI) was observed in the limited number of studies found. More studies are needed to study the association between TNFi use and CVE in general to evaluate a possible protective role in AS.