The Relationship between Long-term use of Nonsteroidal Anti-inflammatory Drugs and Kidney Function in Patients with Ankylosing Spondylitis

Abstract

Background Although nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for ankylosing spondylitis (AS), their effect on kidney function remains unclear. This longitudinal study investigated the correlation between long-term NSAID use and kidney function in patients with AS using electronic medical records. Methods The electronic medical records of 1,280 patients with AS collected from a single center between January 2001 and December 2018 were reviewed. The Assessment of Spondyloarthritis International Society (ASAS) NSAID Intake Score was used to determine the cumulative dose of all NSAIDs prescribed for a different time intervals. Each ASAS NSAID Intake Score was obtained for intervals of 6 months, 1 year, 2 years, 3 years, 5 years, and 10 years. The correlation between the ASAS NSAID Intake Score and final estimated glomerular filtration rate (eGFR) for each interval was investigated. Results The mean ASAS Intake Scores for 6-month, 1-year, 2-year, 3-year, 5-year, and 10-year intervals were 55.30, 49.28, 44.84, 44.14, 44.61, and 41.17, respectively. At each interval, the pearson correlation coefficients were − 0.018 (95% CI: -0.031 ‒ -0.006, p = 0.004), -0.021 (95% CI: -0.039 ‒ -0.004, p = 0.018), -0.045 (95% CI: -0.071 ‒ -0.019, p = 0.001), -0.069 (95% CI: -0.102 ‒ -0.037, p < 0.001), -0.070 (95% CI: -0.114 ‒ -0.026, p = 0.002), -0.019 (95% CI: -0.099 ‒ 0.062, p = 0.645), respectively. There was a very weak negative relationship between ASAS Intake Score and eGFR at each interval. Conclusion Long-term NSAID use did not correlate with kidney function based on real-world data in patients with AS.

DA-9601 has protective effects comparable to those of proton pump inhibitor and rebamipide against nonsteroidal anti-inflammatory drugs-induced upper and lower gastrointestinal bleeding in patients with rheumatoid arthritis: A nationwide study using Korean Health Insurance Review and Assessment Service database

“…Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to manage acute and chronic pain and alleviate symptoms of chronic inflammatory arthritis, such as rheumatoid arthritis (RA), owing to their anti-inflammatory and analgesic properties via cyclooxygenase (COX) inhibition and decreased production of prostaglandins. [1] NSAIDs are categorized into nonselective NSAIDs (nsNSAIDs) and selective COX-2 inhibitors based on the relative degree of inhibiting both COX isoforms – COX-1 and COX-2. COX-1 is constitutively expressed and involved in maintaining homeostasis in the human body.…”