Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

Ricardo da Cruz Lage¹, Claudia Diniz Lopes Marques², Thauana Luiza Oliveira³, Gustavo Gomes Resende⁴, Charles Lubianca Kohem⁵, Carla Gonçalves Saad⁶, Antônio Carlos Ximenes⁷, Célio Roberto Gonçalves⁶, Washington Alves Bianchi⁸, Eduardo de Souza Meirelles⁶, Mauro Waldemar Keiserman⁹, Adriano Chiereghin¹⁰, Cristiano Barbosa Campanholo¹¹, André Marun Lyrio¹², Cláudia Goldenstein Schainberg⁶, Lenise Brandao Pieruccetti¹³, Michel Alexandre Yazbek¹⁴, Penelope Esther Palominos⁵, Rafaela Silva Guimarães Goncalves², Rodrigo Luppino Assad¹⁵, Rubens Bonfiglioli¹², Sônia Maria Alvarenga Anti Loduca Lima¹⁶, Sueli Carneiro¹⁷, Valderílio Feijó Azevedo¹⁸, Cleandro Pires Albuquerque¹⁹, Wanderley Marques Bernardo⁶, Percival Degrava Sampaio-Barros⁶, Marcelo de Medeiros Pinheiro³

Affiliations

¹ Universidade Federal de Minas Gerais (UFMG), Alameda Álvaro Celso 175, Ambulatório Bias Fortes, 2° andar, Belo Horizonte, MG, 30150-260, Brazil. ricolage@gmail.com.
² Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
³ Universidade Federal de São Paulo (UNIFESP/ EPM), São Paulo, SP, Brazil.
⁴ Universidade Federal de Minas Gerais (UFMG), Alameda Álvaro Celso 175, Ambulatório Bias Fortes, 2° andar, Belo Horizonte, MG, 30150-260, Brazil.
⁵ Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
⁶ Universidade de São Paulo (USP), São Paulo, SP, Brazil.
⁷ Hospital Estadual Geral de Goiania (HGG), Goiânia, Brazil.
⁸ Santa Casa de Misericórdia (SCM) do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
⁹ Pontifícia Universidade Católica (PUC) de Porto Alegre, Porto Alegre, RS, Brazil.
¹⁰ Pontifícia Universidade Católica (PUC) de Sorocaba, Sorocaba, SP, Brazil.
¹¹ Santa Casa de Misericórdia (SCM) de São Paulo, São Paulo, SP, Brazil.
¹² Pontifícia Universidade Católica (PUC) de Campinas, Campinas, SP, Brazil.
¹³ Hospital Heliópolis, São Paulo, SP, Brazil.
¹⁴ Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
¹⁵ Ribeirão Preto, Ribeirão Preto, Brazil.
¹⁶ Hospital do Servidor Público do Estado de São Paulo, São Paulo, SP, Brazil.
¹⁷ Universidade Federal do Rio De Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
¹⁸ Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
¹⁹ Universidade de Brasília (UnB), Brasília, DF, Brazil.

PMID: 33468245
DOI: 10.1186/s42358-020-00160-6

Meta-Analysis

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

Ricardo da Cruz Lage et al. Adv Rheumatol. 2021.

. 2021 Jan 19;61(1):4.

doi: 10.1186/s42358-020-00160-6.

Authors

Affiliations

¹ Universidade Federal de Minas Gerais (UFMG), Alameda Álvaro Celso 175, Ambulatório Bias Fortes, 2° andar, Belo Horizonte, MG, 30150-260, Brazil. ricolage@gmail.com.
² Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
³ Universidade Federal de São Paulo (UNIFESP/ EPM), São Paulo, SP, Brazil.
⁴ Universidade Federal de Minas Gerais (UFMG), Alameda Álvaro Celso 175, Ambulatório Bias Fortes, 2° andar, Belo Horizonte, MG, 30150-260, Brazil.
⁵ Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
⁶ Universidade de São Paulo (USP), São Paulo, SP, Brazil.
⁷ Hospital Estadual Geral de Goiania (HGG), Goiânia, Brazil.
⁸ Santa Casa de Misericórdia (SCM) do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
⁹ Pontifícia Universidade Católica (PUC) de Porto Alegre, Porto Alegre, RS, Brazil.
¹⁰ Pontifícia Universidade Católica (PUC) de Sorocaba, Sorocaba, SP, Brazil.
¹¹ Santa Casa de Misericórdia (SCM) de São Paulo, São Paulo, SP, Brazil.
¹² Pontifícia Universidade Católica (PUC) de Campinas, Campinas, SP, Brazil.
¹³ Hospital Heliópolis, São Paulo, SP, Brazil.
¹⁴ Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
¹⁵ Ribeirão Preto, Ribeirão Preto, Brazil.
¹⁶ Hospital do Servidor Público do Estado de São Paulo, São Paulo, SP, Brazil.
¹⁷ Universidade Federal do Rio De Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
¹⁸ Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
¹⁹ Universidade de Brasília (UnB), Brasília, DF, Brazil.

PMID: 33468245
DOI: 10.1186/s42358-020-00160-6

Abstract

Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians' decision making, without taking out his/her autonomy when prescribing for an individual patient.

Keywords: Ankylosing spondylitis; Guidelines; Meta-analysis; Nonsteroidal anti-inflammatory drugs; Spondyloarthritis; Systematic review.

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References

1. Rudwaleit M, Landewe R, van der Heijde D, Listing J, Brandt J, Braun J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 2009;68(6):770–6. - PubMed - DOI
1. Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25–31. - PubMed - DOI
1. Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777–83. - PubMed - PMC - DOI
1. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361–8. - PubMed - DOI
1. Sieper J, van der Heijde D. Review: Nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum. 2013;65(3):543–51. - PubMed - DOI - PMC

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Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

Affiliations

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

Authors

Affiliations

Abstract

References

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Other Literature Sources

Research Materials