We are studying the use of non-steroidal anti-inflammatory drugs (NSAIDs, such as ibruprofen or diclofenac) in axial spondyloarthritis (axSpA). Magnetic Resonance Imaging (MRI) is commonly used to look for inflammation in the sacroiliac joints (the joints where the spine meets the pelvis), something which is a key feature of the disease. Many patients with axSpA take NSAIDs to help manage their pain – these may be over-the-counter medicines, or on prescription from their doctor. We believe, however, that the use of NSAIDs may hide the appearance of inflammation in the sacroiliac joints when viewed on MRI. If this is true, it (a) may prevent some patients from receiving the correct diagnosis; and (b) may mean that some patients are unable to be given the most appropriate medication for their disease. The purpose of this study is to investigate whether, among patients with axSpA, the use of NSAIDs reduces the appearance of inflammation in the sacroiliac joints when viewed with MRI. This will allow us to investigate whether a ‘NSAIDs free’ period helps doctors make a diagnosis of axSpA.
You may be eligible for the study if you:
Our research nurse will ask for more details to check your eligibility with you.
At the moment, we can only recruit patients from the following list of centres. If you are from one of these centres, and think you meet the above criteria, you may be eligible to take part in the DyNAMISM study.
The purpose of our study is to investigate whether, among patients with axSpA, the use of NSAIDs reduces the appearance of inflammation in the sacroiliac joints when viewed with MRI. This will allow us to investigate whether a 'NSAIDs free' period helps doctors make a diagnosis of axSpA. At the end of the study, we may make the recommendation that patients should stop taking NSAIDs, for a short period, before MRI scans. Because of this, it is also important to find out whether patients can tolerate a short period without their NSAIDs, although other pain medication may be taken during this period if required.
If you would like to be involved in DyNAMISM, you need to be eligible and have a local hospital site that is acting as a recruiting centre. Please contact your local recruiting centre and they can advise you about whether you are eligible to take part.
If you volunteer for the study we will ask you to come into your local hospital for an initial visit with a research nurse, after which you will stop taking any NSAIDs for one week. During this visit the research nurse will discuss the NSAIDs free period and answer any further questions. After the one week without NSAIDs you will return for an MRI scan of your sacroiliac joints. The scan will take around 25 minutes, although the total visit may last 1.5 to 2 hours. The scan will be examined by experts who will decide whether there is any inflammation in your sacroiliac joints.
After the scan, you will then restart your usual NSAIDs medication and depending on the results of the first scan, you may be asked to return for a second scan six weeks later. We will also ask you to provide a blood sample and complete questionnaires at each study visit.
If you would like any more information about DyNAMISM, please contact the study office at the University of Aberdeen on 01224 437562 or email the study co-ordinator, email@example.com. You can find the patient information sheet in the documents section below.
This project was funded by Arthritis Research UK and is run by the University of Aberdeen, in conjunction NHS-Grampian. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of Arthritis Research UK, NHS Grampian or University of Aberdeen. Please visit each organisation's website for more information.