NSAIDs don't really work for me. I have tried Enbrel, Remicade, Cimzia (not sure about the spelling on that one), and now I am on Humira. None of them control the pain very well but they do stop the fusion, which is the point. It just depends on the person but if he can get by with just taking NSAIDs, I would agree with Elizabeth, If it ain't broke, don't fix it!

Although, I am no doctor, but I don't think the NSAIDs help with stopping the fusion, they just control the inflammation and help to manage the pain.

Hi Nes, I was diagnosed just over a year ago and was immediately started on Sulfasalazine and MTX but neither worked so now I am on Humira.  But this was because I am unable to take anti-inflammitories, NSAIDS, due to other complications.  I would be happy to just be taking them, I also wish I could take them because they actually help reduce the horrible pain associated with AS. Apparently TNF blockers don't get rid of the pain. I don't completely understand it all myself and I am sure many others don't either but I think your husband is lucky he can take NSAIDS.  Hope he can take them for many years to come. Take care.

I was on NSAIDs for about seven years before I moved on to the TNF inhibitors. They worked pretty well for some of the peripheral arthritis issues - my hands, feet and knees - and they also reduced some of the pain from my spine which had kept me from ever getting a good night's sleep for years. But I'm now 51 and have been experiencing the AS symptoms since my 20's (yes, it took docs over twenty years to diagnose AS, even with very clear markers), and middle age really seems to accelerate the AS symptoms. Your husband might be OK with NSAIDs for many more years - but it's really about quality of life.

There are schools of thought that people should get on the TNF inhibitors right away, to prevent bone damage, but recent studies seem to indicate that they can't prevent that damage - but NSAIDs might. Worth noting is that your husband *must* get regular blood screenings to ensure that his kidneys and liver aren't getting damaged from all the NSAIDs. That's what happened to me - I have damage to my kidneys, and my liver is also showing signs of some issues. But that's not how it goes for everyone. See how things go as time progresses - you'll kind of know when it's time to move onto something stronger. And just keep an eye on NSAID side effects (all medicine has side effects, even aspirin).

My rhumy believes, "If it aint broke, don't fix it."  If the NSAIDS are working, that's great, and they can continue to do the good that they are doing.  The only reason I switched from NSAIDS to immunosuppressive therapy is because over time the NSAIDS stopped working.  They help a lot of people, and some folks are able to stay on them forever.

The advantage to nsaids is that they will slow damage slightly which tnf's don't. The disadvantage is that when taken over long periods they can cause erectile dysfunction in a relatively small percentage but with the likelihood and severity increasing with the longer the use.

I would suggest that he stays on NSAID as long as he can. Immunosupressants are the last thing he should think of. I am also on NSAID and it doesn't remove all the pain but it's manageable. I have to say that I did not have any flares since 9 months but if I have another one and cannot walk or work then I will make the switch but you have to know that TNF blockers have many bad side effects including an increased risks of getting cancer so that is why it should be the last thing to try. Of course if your life is becoming a living hell or ''jail'' then you have to make that decision.I tope this helped.