Understanding Ankylosing Spondylitis and Treatment Concerns
Greetings, I’m F25, and I have just received a diagnosis of ankylosing spondylitis (AS). In addition to AS, I’m also managing ulcerative colitis (UC) for which I’m currently on Stelara, which has proven effective for me. Having previously experienced failures with Remicade and Humira regarding my UC treatment, these options won't be viable for my AS and UC combination. My rheumatologist has recommended a regimen of 90mg of Etoricoxib (also known as Arcoxia) daily for the next three weeks. I have some concerns about potential side effects, particularly those affecting the cardiovascular system. Here are some inquiries I hope to clarify: 1. Is it plausible to develop cardiovascular complications from a three-week course of etoricoxib/Arcoxia, or is a longer duration of use necessary to elevate the risk of such side effects? 2. Might a three-week treatment of etoricoxib/Arcoxia sufficiently reduce inflammation in my sacroiliac joint and potentially lead to remission? My rheumatologist mentioned that a short-term course could be effective and that I could use these medications again during flare-ups. I haven’t come across this information in my research, so I’m curious about its validity. 3. My doctor indicated that aside from celecoxib (Celebrex), etoricoxib/Arcoxia is one of the few non-steroidal anti-inflammatory drugs (NSAIDs) suitable for treating AS in conjunction with UC. This seems to be echoed online; however, I noticed that the medication’s side effects information advises against its use if one has UC. Can you help clarify this contradiction?
Answers (1)
3/27/2025, 10:50:38 PM
OpenHealth AI
Thank you for sharing your situation regarding your recent diagnosis of ankylosing spondylitis (AS) alongside managing ulcerative colitis (UC). It’s completely understandable to have concerns about the treatment options and their potential side effects. Let’s address your questions to help clarify these important points.
Key Points
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Cardiovascular Risks with Etoricoxib
Easing your mind, the risk of cardiovascular complications from a short, three-week course of etoricoxib is generally low, especially if you do not have other significant risk factors (like pre-existing heart disease, high blood pressure, or other conditions). Long-term use (months or years) is usually associated with higher risks. -
Effectiveness for Inflammation
A three-week course of etoricoxib can indeed help reduce inflammation in conditions like AS. Many patients respond positively to a short-term NSAID treatment, and it can assist in managing flare-ups effectively. Your rheumatologist's recommendation aligns with practices that many find beneficial for symptom control. While complete remission might take longer in chronic conditions, a reduction in symptoms is realistic and often achieved. -
Contraindications with Ulcerative Colitis
The caution against using etoricoxib in the presence of UC likely arises from concerns regarding GI side effects, such as exacerbation of colitis symptoms or increased risk of gastrointestinal bleeding, which is a risk associated with many NSAIDs. However, etoricoxib is sometimes considered when patients have doped well with certain conditions due to its safety profile relative to traditional NSAIDs. Since your case involves careful management under a specialist's guidance, your rheumatologist’s suggestion can be appropriate if they monitor your condition closely.
Next Steps to Consider
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Monitor Symptoms: Keep a daily log of your symptoms during the treatment. Note any changes, improvements, or side effects that arise; this will help you and your doctor assess the treatment's effectiveness and adjust if necessary.
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Stay Aware of Side Effects: Be mindful of any heart-related symptoms (like chest pain, shortness of breath) and gastrointestinal symptoms (like unusual abdominal pain or changes in bowel habits) and report them immediately.
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Follow-up with Your Doctor: Maintain open communication with your rheumatologist. If any concerns about cardiovascular risks or GI symptoms arise, your doctor can adjust the treatment strategy or recommend additional supportive therapies.
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Consider Non-Medical Management: Incorporate physical therapy and exercises appropriate for AS under the guidance of a health professional, as this can also help manage symptoms alongside medication.
Your proactive approach toward understanding your treatment options is commendable. If you have more queries or need further clarification on any specific point, feel free to ask!
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