NSAID and Anti-TNF Therapy vs Anti-TNF Therapy on the Spine in Patients with Axial Spondyloarthritis .
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Comparison of the effect of treatment with NSAIDs added to anti-TNF therapy versus anti-TNF therapy alone on the progression of structural damage in the spine over 2 years in patients with radiographic axial spondyloarthritis from the randomised-controlled CONSUL trial
Ann Rheum Dis . 2024 Apr 11;83(5):599-607.One hundred and nine patients with radiographic axial spondyloarthritis (r-axSpA) were randomized to receive combination therapy with golimumab and celecoxib (n=54) or golimumab monotherapy (n=55). The primary outcome was the change in radiographic spinal progression as measured by the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) over two years. Secondary outcomes included syndesmophyte formation, disease activity, physical function, spinal mobility, and quality of life. The study revealed no statistically significant difference in mSASSS progression between the combination therapy and monotherapy groups (1.1 vs. 1.7; p=0.79), although a numerical trend favored combination therapy. The findings suggest limited benefits of combination therapy for routine clinical use, although it may be relevant in select high-risk patients.
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