CClinicalTrials.gg
CompletedNCT02469753STOPUpdated May 19, 2026

Interest of Continuous Non-Steroidal Anti-Inflammatory Drug Treatment in Ankylosing Spondylitis Patients Treated by Anti-TNF Therapy in the Prevention of Radiographic Outcomes

A Phase 3 interventional study of NSAIDs and NSAIDs in Ankylosing Spondylitis, sponsored by University Hospital, Bordeaux. Completed at 22 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-19.

Sponsored by University Hospital, Bordeaux · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
188
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Ankylosing spondylitis (AS) is a frequent chronic inflammatory rheumatic disease that affects the axial skeleton, starting in the sacroiliac joints and spreading to the spine in most patients. Non-steroidal anti-inflammatory drugs (NSAIDs) are the primary treatment for AS. Even if the use of anti-TNF agents has demonstrated good clinical efficacy in controlling inflammation, in contrast to other conditions such as rheumatoid arthritis and psoriatic arthritis, anti-TNF treatment has failed to demonstrate any benefit on the structural progression of AS, some data even suggesting that it may accelerate the formation of syndesmophytes that seems to be an independent process of TNF. Conversely, NSAIDs inhibit ossification phenomena independently of their anti-inflammatory properties, owing to a specific action on bone formation via prostaglandin inhibition.

Several features suggest that a continuous NSAID therapy is needed, in addition to anti-TNF treatment, to prevent syndesmophyte formation in AS patients.

02

Conditions studied

  • Ankylosing Spondylitis

Keywords

  • NSAIDs
  • Anti-TNF
  • syndesmophytes
  • mSASSS
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients aged over 18 years old
  • Patients who fulfil 1984 modified New York criteria for ankylosing spondylitis:
  • SA patients with indications for anti-TNF treatment initiation according to the French society of Rheumatology guidelines.
  • Being affiliated to a health insurance system
  • Having signed an informed consent form (later than the day of inclusion and before any examination required by the research)

Exclusion criteria

Exclusion Criteria:

  • Patients who present another chronic systemic inflammatory disorder, different from ankylosing spondylitis.
  • Patients who present contraindications to treatment with NSAIDs.
  • Patient with daily corticosteroid treatment at a dosage ≥ 10 mg/day
  • Pregnant or breastfeeding women
  • Contra-indication to MRI (pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments or foreign objects in the eyes, skin or body, claustrophobia) or refusing to undergo MRI
  • Women that refuse to an effective contraception method for all the study duration
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
188 participants (actual)

Study arms

  • Experimental
    Patients treated with anti-TNF and continuous daily NSAIDs

    Drug: NSAIDs · Drug: anti-TNF

  • Active comparator
    Patients treated with anti-TNF and NSAIDs on demand

    Drug: NSAIDs · Drug: anti-TNF

Interventions

  • DrugNSAIDs

    continuous daily

  • DrugNSAIDs

    on demand

  • Druganti-TNF
05

What researchers measure

Primary outcomes

  1. Proportion of patients who show a significant radiographic progression between the two randomised groups of patients

    Time frame: 24 month after the begin of the treatment

Secondary outcomes

  1. Radiologic evolution between-group comparison

    This measure is a composite with : * MRI * Clinical evolution of patients * Quantitative analysis of mSASSS score

    Time frame: At the inclusion (Day 0) and 24 month after after the inclusion (Day 0)(begin of the treatment)

06

Study locations

22 sites
  • Service de rhumatologie - CHU d'Amiens
    Amiens, France
  • Service de rhumatologie - CHU de Besançon
    Besançon, France
  • Service de Rhumatologie - CHU de Bordeaux
    Bordeaux, France
  • service de rhumatologie - AP-HP - Hôpital Ambroise Paré
    Boulogne-Billancourt, France
  • Service de rhumatologie - CHU de Brest
    Brest, France
  • service de rhumatologie - CH de Cahors
    Cahors, France
  • service de rhumatologie - CH Le Mans
    Le Mans, France
  • service de rhumatologie - CHU de Limoges
    Limoges, France
  • service de rhumatologie - CHU de Montpellier
    Montpellier, France
  • service de rhumatologie - CHU de Nancy
    Nancy, France
  • Service de rhumatologie - CHU de Nice
    Nice, France
  • service de rhumatologie - CHR d'Orléans
    Orléans, France
  • service de rhumatologie - AP-HP - Hôpital Henri Mondor
    Paris, France
  • Service de rhumatologie - AP-HP - Hôpital Lariboisière
    Paris, France
  • service de rhumatologie - AP-HP- Hôpital La Pitié Salpétrière
    Paris, France
  • service de rhumatologuie - CH de Pau
    Pau, France
  • service de rhumatologie - CHU de Rouen
    Rouen, France
  • service de rhumatologie - CHU de Saint-Etienne
    Saint-Etienne, France
  • service de rhumatologie - CHU de Strasbourg
    Strasbourg, France
  • service de rhumatologie - CHU de Toulouse
    Toulouse, France
  • Service de rhumatologie - CHU de Tours
    Tours, France
  • service de Rhumatologie - CH Princesse Grace
    Monaco, Monaco
07

Registry details

Key details

Study ID
NCT02469753
Lead sponsor
University Hospital, Bordeaux
Responsible party
Sponsor
First posted
Jun 11, 2015
Start date
Oct 23, 2015
Primary completion
Jul 4, 2024
Completion
Jul 4, 2024
Last update
May 19, 2026

Study contacts

Rodolphe THIEBAUT, Prof
study chair · University Hospital Bordeaux, France
Thierry SCHAEVERBEKE, Prof
principal investigator · University Hospital Bordeaux, France

Oversight

Data monitoring committee
No
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