Journal of Rawalpindi Medical College | 2026
Authors: Abbasi Q.-U.-A.; Khaliq T.; Shah S.A.; Shafqat S.; Rehman A.
DOI: 10.37939/jrmc.v30i1.3004
Journal: Journal of Rawalpindi Medical College
Year: 2026
Publisher: Rawalpindi Medical University
Document Type: Article
Open Access: All Open Access; Gold Open Access
Cited by: 0
Objective: This study aimed to evaluate cumulative nonsteroidal anti-inflammatory drug (NSAID) usage in patients with ankylosing spondylitis (AS) using the Assessment of SpondyloArthritis International Society (ASAS)-NSAID score and to assess its changes following the initiation of biological disease-modifying anti-rheumatic drugs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs). Methods: A quasi-experimental cross-sectional study was conducted at the Rheumatology Clinic of the Federal Government Polyclinic Hospital from July to December 2024. Sixty patients with spondyloarthritis (SpA), diagnosed according to the ASAS criteria, were enrolled. The ASAS-NSAID score was calculated at baseline and reassessed after six months in 43 patients receiving b/tsDMARDs. Disease activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP). Statistical analyses included the Wilcoxon Signed-Rank Test, Mann-Whitney U test, and Kruskal-Wallis test. Results: Of 60 patients (73.3% male; mean age, 32.97 ± 8.96 years), the baseline mean ASAS-NSAID score was 30.15 ± 25.63. In the 43 patients receiving b/tsDMARDs, the score significantly decreased to 1.28 ± 1.80 (p < 0.001) post-treatment. The ASAS-NSAID score showed a statistically significant association with disease activity, as measured by the BASDAI (p = 0.007), and with NSAID dosage groups (p = 0.002; Kruskal-Wallis test). No significant association was found with ASDAS-CRP (p = 0.242), NSAID type (p = 0.107), or sex (p = 0.069). Conclusions: The ASAS-NSAID score effectively quantifies NSAID use in AS, with a significant reduction after b/tsDMARDs, highlighting the NSAID-sparing effect and supporting early biologic intervention to minimise NSAID-related risks. © 2026.
Anti-Inflammatory Agents, Non-Steroidal; Biological Products; Disease Progression; Spondylitis, Ankylosing; Treatment Outcome