What Is Nonradiographic Axial Spondyloarthritis (nr-axSpA)?
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Treating nr-axSpA
Miller believes that as a treatment for nr-axSpA, exercise is “hands down the most important thing for someone who hasn’t been diagnosed, or someone who has been.” This is confirmed by official guidelines, he notes, which recommend that “if someone has active inflammatory back pain, an exercise regimen, usually under the guidance of a physical therapist, is part of the initial management.”
NSAIDs “are still first-line treatments,” Miller emphasizes. “There’s been a lot of redirection toward biologic medicines,” but treatment guidelines recommend considering this newer group of drugs when NSAIDs fail to control the disease.
NSAIDs that may be prescribed for nr-axSpA include:
One downside of NSAIDs is their potential side effects, which often include gastrointestinal irritation — potentially leading to heartburn, stomach inflammation (gastritis), and even gastrointestinal bleeding. They may also contribute to heart or kidney problems over the long term.
If NSAIDs don’t control your nr-axSpA well enough, your doctor may prescribe a biologic drug. Specifically, a class of drugs called TNF inhibitors has been shown to be effective at reducing inflammation in nr-axSpA, including in areas outside your spine.
But treatment guidelines from the American College of Rheumatology don’t recommend one particular TNF inhibitor over another, and doctors are free to prescribe any of them for nr-axSpA. They include:
Liew looks forward to the results of further clinical trials of biologic drugs for nr-axSpA, “so that we can hopefully get FDA approval soon for all the things that are already approved for AS.”
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