Non-Steroidal Anti-Inflammatory Drug Etoricoxib Facilitates the Application of Individualized Exercise Programs in Patients with Ankylosing Spondylitis

Abstract

Background and objectives: The main objective of this study is to highlight the efficiency of different therapeutic means in patients with ankylosing spondylitis, resulting in the improvement of their quality of life. Materials and Methods: We conducted a randomized, longitudinal, controlled trial on 92 patients with ankylosing spondylitis over a period of 6 years. Disease activity was assessed using the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) score. The assessment of functional disabilities was performed using BASFI (Bath Ankylosing Spondylitis Functional Index). We assessed the quality of life using the HAQ questionnaire (Health Assessment Questionnaire). Based on the HAQ, we calculated the minimum number of patients to be treated for 52 weeks to prevent a decrease in the quality of life for at least one of them (the number needed to treat (NNT)). Results: For the combination therapy group, the result we obtained was 2, lower than the other therapies compared (the medication group and the group with physical exercise). We point out a correlation between the improvement of the functional status (BASFI) and the increase of the quality of life (HAQ), estimated as moderately high (0.8). The superiority of the effects of the combined treatment, in which we combined a nonsteroidal anti-inflammatory drug (etoricoxib) to the exercise program, is reflected by the model of the significant improvements (p < 0.05) obtained for the functional status and quality of life scores (BASFI and HAQ). Conclusions: The nonsteroidal anti-inflammatory drugs, in our case, etoricoxib, facilitate the application of individualized exercise programs in patients with ankylosing spondylitis.

The Role of Clinical and Ultrasound Enthesitis Scores in Ankylosing Spondylitis

“…Moreover, BASDAI is a subjective method of determining disease activity, the ASDAS score being a more reliable tool in assessing disease activity. In fact, not all tests used to quantify enthesitis measure the same characteristics; thus, there is a discrepancy between the scores of overall clinical activity and the disease activity at the entheseal level [ 18 , 19 ].…”

Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

“…81 Eight studies on NSAIDs were included, of which two non-inferiority RCTs in r-axSpA, one at low and one at unclear RoB (Table 2). [82][83][84][85][86][87][88][89] The first study demonstrated non-inferiority of two doses of etoricoxib (60 and 90 mg daily) versus naproxen 1000 mg daily on VAS spinal pain (SMD between etoricoxib 60 mg and 90 mg with naproxen: 0.07 (−0.24, 0.10) and 0.03 (−0.19, 0.26). 82 The second RCT demonstrated the non-inferiority of two doses of celecoxib (400 mg and 200 mg) versus diclofenac 150 mg daily in VAS global pain (SMD not possible to calculate).…”