IBP, a hallmark of axSpA, typically shows a good and rapid response to NSAIDs, which serves as both a diagnostic clue and a cornerstone of initial therapy. A favorable response to NSAIDs helps distinguish IBP from mechanical back pain, which often fails to improve or may even worsen with such treatment. This characteristic response is incorporated into classification criteria as a supportive feature of axSpA.
NSAIDs remain the first-line pharmacological option, effectively reducing pain and inflammation while improving functional outcomes. Moreover, continuous use in some patients may confer a disease- modifying effect by decreasing inflammatory activity and potentially slowing radiographic progression. However, their use must be carefully balanced against possible adverse effects, including GI, cardiovascular, and renal risks.
REFERENCE
1. Baraliakos X, Bergmann E, Tsiami S, Redeker I, Braun J. A Good Response to Nonsteroidal Antiinflammatory Drugs Does Not Discriminate Patients With Longstanding Axial Spondyloarthritis From Controls With Chronic Back Pain. J Rheumatol. 2024 Mar 1;51(3):250- 256.
2. Weisman SM, Ciavarra G, Cooper G. What a pain in the … back: a review of current treatment options with a focus on naproxen sodium. J Pharm Pharm Sci. 2024 Feb 7;27:12384.