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Non-steroidal anti-inflammatory drugs (NSAIDs) and physiotherapy constitute the standard treatment for patients with ankylosing spondylitis (AS). Currently, there are no good disease modifying agents. Tumour necrosis factor antagonists, though effective, are very expensive and associated with an increased risk of infections. Pamidronate, an amino bisphosphonate is believed to have anti-inflammatory properties. We evaluated the role of pamidronate infusions in patients with AS refractory to NSAIDs.
Twenty one patients fulfilling modified New York criteria1 for AS with active disease despite use of the maximal dose of two NSAIDs were recruited. Active peripheral arthritis and use of disease modifying antirheumatic drugs were reasons for exclusion. The mean (SD) age of the patients (male:female 20:1) was 31.6 (8.7) years and the mean (SD) disease duration 9.2 (5.5) years. The treatment regimen comprised monthly pamidronate infusions (60 mg over 4 hours) …