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Study to assess whether painkillers ‘hide’ axial spondyloarthritis

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The University of Aberdeen has launched a study to find out whether people with an inflammatory arthritis condition are being misdiagnosed because of the painkillers they are using.

The research, funded by Arthritis Research UK, aims to see how big a role patients’ medication plays in slowing down diagnosis of axial spondyloarthritis.

Axial spondyloarthritis is a form of inflammatory arthritis which affects the spine and joints in the pelvis, and in extreme cases can lead to parts of the spine fusing together. There is no cure but the condition can be managed with special anti-inflammatory medication.

According to the University of Aberdeen, an estimated 700,000 people in the UK live with inflammatory back pain.

Most manage the pain with anti-inflammatory drugs such as ibuprofen while they wait to have the condition formally diagnosed by a rheumatologist. However, there are concerns that in some cases these drugs are reducing the inflammation to the point where the symptoms become hidden. This means that MRI scans to diagnose the condition are incorrectly coming back negative.

Early diagnosis is key to preventing axial spondyloarthritis getting worse, but typically it can take between eight and 11 years to be properly identified.

The new study will give an indication as to what proportion of axial spondyloarthritis cases are misdiagnosed as a result of the painkillers.

For the research, 250 patients with axial spondyloarthritis will be recruited from around 20 different centres and asked to stop taking their regular anti-inflammatory drugs for a week before having an MRI scan. They will then start taking the drugs again for six weeks, ahead of a second MRI scan.

The researchers will then compare the proportion of people who scanned positive for axial spondyloarthritis with those who scanned negative for the condition once they went back on the painkillers.

Lead researcher Dr Gareth Jones, a musculoskeletal pain and spondyloarthritis expert, said: “The fact that it can take up to 11 years to get a formal diagnosis of axial spondyloarthritis is obviously a concern. There are good drugs to help people manage the condition but they are only available to people who get a correct diagnosis.

“If we see that the painkillers are indeed leading to negative diagnoses, then it will lend support to the argument that anyone receiving an MRI scan for back pain should halt their regular anti-inflammatory medication for a week or so prior to the scan.”