Among patients with axial spondyloarthritis, we found that taking common anti-inflammatory medication (NSAIDs, such as ibuprofen or naproxen) can hide signs of joint inflammation on MRI scans. This may lead to an under-estimation of the disease in patients with the disease, or perhaps an under-diagnosis among those not yet diagnosed.
As part of the DyNAMISM study, 124 patients underwent an MRI scan on two separate occasions: once after stopping their NSAID medication for 1-2 weeks, and once again 6 weeks after restarting. Comparing the scans, we saw a decrease in the visible inflammation in the joints at the base of the back where the spine meets the pelvis (sacroiliac joints) in over 40% of patients once they had resumed daily treatment. In fact, in 1 in 5 patients, the scans appeared to show 'normal' amounts of inflammation when back on medication when compared to without.
Based on this research, we recommend that clinical guidelines should be updated to recommend that patients with axial spondyloarthritis should temporarily stop taking their anti-inflammatory medication for 14 days before an MRI scan, to ensure that the scan is most helpful.
You should always speak to your doctor before doing this. However, reassuringly, we also found that almost all patients were able to tolerate the brief 1-2 week break from their medication in order to prepare for the scan, with most experiencing only modest increases in pain.
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You can read the full paper of this research here.