Background Ankylosing Spondylitis (AS) may result in loss of mobility and function; therefore, patients can experience pain and stiffness with a loss of physical function in addition to severe impairment in their quality of life. Standard treatment of AS consists of nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.

Objectives The aim of this study was to compare the effectiveness of DMARD therapies on requirements for NSAIDs, disease activity, fear of movement, and quality of life in AS patients.

Methods A total of 74 patients diagnosed according to the modified New York criteria for AS were enrolled. To calculate NSAID intake, the type of NSAID, dose, and percentage of days with intake were recorded in conjunction with DMARD therapy, age, body mass index (BMI), and disease duration. Patients were assessed to measure several parameters: 1) disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 2), fear of movement as assessed by the Tampa Scale for Kinesiophobia (TSK); and 3) quality of life using the Ankylosing Spondylitis Quality of Life Scale (ASQoL) status from the patient's perspective.

Results Seventy-four patients (36 women, 38 men; mean age: 43.81±10.18 years; mean disease duration: 9.89±8.50 years; BMI: 28.20±5.07) treated with four different DMARDs (Adalimumab+Golimumab [ADA+GO]=17; Infliximab [INFX]=19; Etanercept [ETA]=13; Sulphasalazine [ST]=25) were included. NSAID intake was significantly lower in the INFX therapy group (mean: 28.1±81.5) compared to the ADA+GO (mean: 33.3±76.0), ETA (mean: 33.5±58.2), and ST therapy groups (mean: 68.1±76.1) (p=0.003). BASDAI scores (mean: 3.9±2.4), NSAID intake (mean: 68.1±76.1; p=0.003), and AS-QoL scores (mean:10.2±7.4) were significantly higher in the ST group compared to the other drug groups. TSK scores were also similar between different NSAID intake groups (p=0.089).

Conclusions According to our results, ST was not effective enough even with concomitant therapy consisting of a single oral dose of NSAID or standard doses of oral corticosteroids in terms of disease activity, fear of movement, and quality of life in AS patients.

References

1. Braun J, Baraliakos X, Heldmann F, et al. Tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthritis. Expert Opin Investig Drugs. 2014;23:647–659.

2. Rohekar S, Chan J, Tse SM, et al. 2014 update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondy- loarthritis. Part I: principles of the management of spondyloarthritis in Canada. J Rheumatol. 2015;42:654–664.

3. Rohekar S, Chan J, Tse SM, et al. 2014 update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondy- loarthritis. Part II: specific management recommendations. J Rheu- matol. 2015;42:665–681.

References

Acknowledgements We would like to thank Rheumatology Nurse Ayten Yuksek in our department for monitoring and documenting of the data, and our patients for assistance with their valuable participation to our study.

Disclosure of Interest None declared