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

• Main Authors: Ricardo da Cruz Lage, Claudia Diniz Lopes Marques, Thauana Luiza Oliveira, Gustavo Gomes Resende, Charles Lubianca Kohem, Carla Gonçalves Saad, Antônio Carlos Ximenes, Célio Roberto Gonçalves, Washington Alves Bianchi, Eduardo de Souza Meirelles, Mauro Waldemar Keiserman, Adriano Chiereghin, Cristiano Barbosa Campanholo, André Marun Lyrio, Cláudia Goldenstein Schainberg, Lenise Brandao Pieruccetti, Michel Alexandre Yazbek, Penelope Esther Palominos, Rafaela Silva Guimarães Goncalves, Rodrigo Luppino Assad, Rubens Bonfiglioli, Sônia Maria Alvarenga Anti Loduca Lima, Sueli Carneiro, Valderílio Feijó Azevedo, Cleandro Pires Albuquerque, Wanderley Marques Bernardo, Percival Degrava Sampaio-Barros, Marcelo de Medeiros Pinheiro
• Format: Article
• Language: English
• Published: BMC 2021-01-01
• Series: Advances in Rheumatology
• Subjects: Spondyloarthritis; Ankylosing spondylitis; Nonsteroidal anti-inflammatory drugs; Systematic review; Meta-analysis; Guidelines
• Online Access: https://doi.org/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.