A diagnostic tool for spondylo- arthropathy NSAIDs are the first line treatment in ankylosing spondylitis (AS) and to a large extent in painful clinical manifes-

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) effects in Ankylosing Spon-dylitis (AS) are only suspensive but because of their rapid efficacy on inflam-matory symptoms they are the first-line treatment in AS. Short term efficacy of NSAIDs in AS is observed for most patients but the correlation of NSAID intake with the long term prognosis and its potential influence on the structural progression of the disease is still unknown. Therefore, and due to the gas-trointestinal side effects of these drugs, daily practice is mostly in favour of dis-continuous intake of NSAIDs, following the clinical re l apses. Howeve r, t h e recent introduction of specific Cox-2 inhibitors, with a lower risk of severe ga s t rointestinal adve rse eve n t s , m ay modify this at t i t u d e. More ove r, s o m e p atients are inadequat e ly re l i eved of pain and inflammation by NSAIDs. The number of NSAIDs to be tested and for each NSAID, the optimal dosage that must be used befo re cat ego rizing a patient as «refractory to NSAID thera-py» have to be clarified. The recent determination of response and remission criteria for NSAIDs therapy is the first s t ep towa rds we l l-d e fined guidelines for short-term and long-term management of NSAIDs in AS. A diagnostic tool for spondylo-arthropathy NSAIDs are the first line treatment in ankylosing spondylitis (AS) and to a large extent in painful clinical manifest ations of art h ritis or enthesiopat h i e s observed in spondyloarthropathy. The remarkable efficacy of NSAIDs with a q u i ck-acting symptomatic effect is a diagnostic criteria according to Amor cl a s s i fi c ation wh i ch includes twe l ve items, each of them counting for one to t h ree points (1). A minimum of six points are necessary to classify a patient as suffering from a spondyloarth-ropathy. Item 12 is relative to NSAIDs efficacy: " clearcut improvement within 48 hours after NSAID intake or rapid relapse of pain after their discontinua-tion ". Its value of two points in this cl a s s i fi c ation illustrates the notabl e weight of NSAIDs response in a diagnostic approach. A multicenter cross-sectional study conducted in 741 patients complaining of back pain (69 AS and 672 controls) permitted calculation of the positive and …