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Etoricoxib in ankylosing spondylitis: is there a role for active patients refractory to traditional NSAIDs?
J. Gratacós1, M. Moreno martínez-Losa2, P. Font3, C. Montilla4, C. Fernández-Espartero5, L.F. Linares6, E. Brito7, J.C. Oliva8, E. Collantes-Estevez9
- Rheumatology Unit, Hospital Universitario Parc Taulí, Sabadell, Spain. jgratacosmas@gmail.com
- Rheumatology Unit, Hospital Universitario Parc Taulí, Sabadell, Spain.
- Rheumatology Unit, Hospital Universitario Reina Sofía, IMIBIC, Córdoba, Spain.
- Rheumatology Unit, Hospital Universitario de Salamanca, Spain.
- Rheumatology Unit, Hospital Universitario de Móstoles, Madrid, Spain.
- Rheumatology Unit, Hospital Virgen de Arrixaca, Murcia, Spain.
- Rheumatology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Statistics Department, Hospital Universitario Parc Taulí, Sabadell, Spain.
- Rheumatology Unit, Hospital Universitario Reina Sofía, IMIBIC, Córdoba, Spain.
and the Etoricoxib Study Group
CER8597
2016 Vol.34, N°1
PI 0094, PF 0099
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PMID: 26812050 [PubMed]
Received: 11/05/2015
Accepted : 02/09/2015
In Press: 20/01/2016
Published: 10/02/2016
Abstract
OBJECTIVES:
To evaluate the efficacy of etoricoxib in patients with axial ankylosing spondyloarthritis (AS) refractory to traditional NSAIDs.
METHODS:
This was an open label, multicentric, randomised, prospective (4 weeks with and open extension to 6 months), non-controlled study. Consecutive patients with axial AS refractory to traditional NSAID eligible for anti-TNF-α therapy were selected. The primary outcomes were the rate of patients with good clinical response (not eligible for anti-TNF-α therapy after etoricoxib) and the Assessment of Spondyloarthritis International Society response criteria for biologic therapies (ASASBIO) response at 4 weeks. Secondary outcomes included: ASAS20 and 40 responses, ASDAS-CRP response, BASDAI, BASFI, back and night back pain, global patient and physician assessment of the disease, and biologic parameters like C-reactive protein (CRP) at 2, 4 weeks and 6 months.
RESULTS:
A total of 57 axial AS patients were recruited, 46 men, with mean age of 43 years. After 4 weeks of treatment, 26 patients (46%) achieved a good clinical response and 11 (20%) an ASASBIO response. These results at 24 weeks were 19 (33%) and 13 (23%) respectively. All individual clinical variables improved significantly after 4 weeks of treatment. CRP serum levels decreased after 4 weeks but reached no statistical significance, although 30% of patients showed a normalisation of CRP.
CONCLUSIONS:
Etoricoxib provided a clear clinical improvement in around a third of patients with axial AS refractory to traditional NSAIDs. Special care should be required when deciding to start anti-TNF-α therapy; it seems reasonable to keep in mind these results of etoricoxib treatment.