Ten-year results from the GESPIC study support the use of NSAIDs for reducing radiographic spinal progression in patients with axial spondyloarthritis and suggest a stronger effect with cyclo-oxygenase-2 selective inhibitors than non-selective NSAIDs.

Nakata K et al. Osteoarthritis Cartilage 2018. doi: 10.1016/j.joca.2018.05.021

A monthly selection of topical peer-reviewed articles from the Adis journals, curated by the editors.

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3–9 November: Keep up with the latest news and interviews from the conference.

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5 – 9 November: Preview the conference with session recommendations and updates on upcoming coverage.

How will the FAST trial results impact regulatory guidance & clinical practice?

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Experts discuss the increasing use of telemedicine in rheumatology during the COVID-19 pandemic.

Jean-Pierre Pelletier (University of Montréal Hospital Research Centre, Québec, Canada) and co-authors explain that although COX-2 inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and analgesics such as acetaminophen “are popular for acute flare-ups of the disease, their use for an extended period could lead to significant adverse events (AEs) such as cardiovascular diseases, renal and liver toxicity.”

In a subgroup analysis by NSAID type, the team estimated that around 29% of the OA-associated CVD risk was mediated by conventional NSAIDs including diclofenac, ibuprofen, and naproxen, while 21% was accounted for by selective COX-2 inhibitors including celecoxib, lumiracoxib, rofecoxib, and valdecoxib.

Smith SM, Cooper-DeHoff RM.  Am J Med  2018. doi: 10.1016/j.amjmed.2018.08.027

And he added: “Patients should continue to consult their doctor before taking NSAIDs or [COX-2 inhibitors] and clinicians need to weigh the potential hazards of worsening blood pressure control when considering the use of these agents.”

As the gastrointestinal toxic effects of non‑selective NSAIDs are linked to COX-1 inhibition, the development of selective COX-2 inhibitors offers the potential to retain COX-2 inhibition benefits whilst not exposing the gastrointestinal tract to COX-1-related adverse effects.