Review Paper on Ankylosing Spondylitis and the Implications of NSAIDS Use on Renal Function

Sekhar Vijay Ganguluri; Naga Subrahmanyam S; Ravi Prakash Degala; Anusha Panchadi; Surya Tejaswini Devu; Swathi Meruva

doi:10.37022/jcscr.v3i2.627

Ganguluri Sekhar Vijay I/VI Pharma-D, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India.
Naga Subrahmanyam S Associate Professor, Department of Pharmacy Practice, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India.
Ravi Prakash Degala Associate Professor, Department of Pharmacy Practice, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India.
Panchadi Anusha Assistant Professor, Department of Pharmacy Practice, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India
Devu Surya Tejaswini Assistant Professor, Department of Pharmacy Practice, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India
Meruva Swathi Assistant Professor, Department of Pharmacy Practice, Koringa College of Pharmacy, Korangi-533461, Tallarevu Mandal, Kakinada District, Andhra Pradesh, India

DOI https://doi.org/10.37022/jcscr.v3i2.627

Abstract

Background: Ankylosing spondylitis (AS), a type of axial spondyloarthritis, is a chronic inflammatory condition primarily affecting the spine and pelvis. It can lead to spinal fusion, reducing flexibility and potentially causing a hunched posture and compromised respiratory function1. AS is categorized into radiographic ankylosing spondylitis (visible on X-ray) and nonradiographic axial spondyloarthritis (detected through symptoms and other diagnostic methods).Objective: This study examines the safety and impact of nonsteroidal anti-inflammatory drugs (NSAIDs) on renal function in patients with ankylosing spondylitis and evaluates the efficacy and risks associated with various treatment options. Methods: We reviewed the effects of NSAIDs on renal health, particularly focusing on the potential for renal impairment and the influence of NSAIDs' COX-1and COX-2 selectivity. Data were analyzed from multiple sources including population-based studies and clinical trials2. Additionally, the impact of tumor necrosis factor (TNF) inhibitors and interleukin-17 (IL-17) inhibitors on renal function was assessed in patients with preexisting renal risks. Results: NSAIDs are effective in managing AS symptoms but can pose risks to renal function, particularly in patients with preexisting conditions such as older age, reduced renal function, or comorbidities. The study found that while NSAIDs generally do not cause significant renal deterioration in the broader AS population, they can exacerbate renal issues in susceptible individuals. The analysis also highlighted differences in the renal safety profiles of COX-2 selective inhibitors versus non-selective NSAIDs, with COX-2 inhibitors showing fewer adverse renal effects5.Conclusion: The findings suggest that while NSAIDs are effective for AS management, their use requires careful consideration of the patient's renal status and risk factors. In patients with existing renal impairment or other risk factors, alternative therapies or more stringent monitoring may be necessary. Further research is needed to refine guidelines for NSAID use in AS, especially regarding long-term renal safety and the comparative efficacy of newer biologic treatments.

Keywords: NSAIDS, Ankylosing spondylitis, renal function, glomerular filtration rate, tumor necrosis factor

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