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A new study is being launched in the UK to determine whether people with axial spondyloarthritis are being misdiagnosed because of the painkillers they are using.
The University of Aberdeen study, funded by Arthritis Research UK, will examine how big a role patients' medication plays in slowing down the diagnosis of axial spondyloarthritis, and to establish whether new approaches to treating and diagnosing the disease are needed.
How painkillers may mask the signs of axial spondyloarthritis
Axial spondyloarthritis is an inflammatory arthritic condition affecting around 700,000 people in the UK. It afflicts the spine and joints in the pelvis and, in extreme cases, can lead to parts of the spine fusing together.
Many people manage the pain the disease causes with anti-inflammatory drugs, such as ibuprofen, while they wait to have the condition formally diagnosed by a rheumatologist, but concerns are emerging that these drugs are reducing the inflammation to the point where the symptoms become hidden.
This means that subsequent MRI scans to diagnose the condition are incorrectly coming back negative, resulting in a situation in which it typically takes between eight and 11 years properly identify this disease.
How the study will work
In this new study, 250 patients with axial spondyloarthritis will be recruited from around 20 different centres and asked to stop taking their regular anti-inflammatory drugs for a week before receiving an MRI scan. They will then start taking the drugs again for six weeks, ahead of a second MRI scan.
The researchers will compare the proportion of people who scanned positive for axial spondyloarthritis with those who scanned negative for the condition once they went back on the drugs, giving an insight into the degree to which these therapies can cause misdiagnosis.
Lead researcher Dr Gareth Jones, a musculoskeletal pain and spondyloarthritis expert, said: "If we see that the painkillers are indeed leading to negative diagnoses, then it will lend support to the argument that anyone receiving an MRI scan for back pain should halt their regular anti-inflammatory medication for a week or so prior to the scan."
Arthritis Research UK's view
Stephen Simpson, director of research and programmes at Arthritis Research UK, said: "Axial spondyloarthritis is an incredibly painful condition, which can have a devastating impact on a person's everyday life. For example, those with ankylosing spondylitis are three times more likely to stop work than the general population.
"This new research will prompt conversations around whether patients should be asked to refrain from taking nonsteroidal anti-inflammatory drugs immediately prior to an MRI scan and to rely, instead, on other pain relief during this specific period. This research could lead to earlier diagnosis for people living with the condition, leading to earlier commencement of appropriate treatment and improved outcome."
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