Yang C et al. - Traditional NSAIDs are relatively cheap and more readily available than selective COX-2 inhibitors in Asian countries. Diseasemodifying agents widely used in SpA include sulfasalazine (SSZ), thalidomide, methotrexate (MTX) and leflunomide. SSZ and MTX are the most frequently used in patients with SpA, even though there are few clinical trials to verify their efficacy. Thalidomide is potentially useful in treating severe and refractory AS patients. Tumor necrosis factor (TNF) inhibitors have been shown to be effective in the treatment of AS, but more attention needs to be given to potential tuberculosis (TB) infection. Traditional herbal medicine and acupuncture are also used in relieving pain and improving function in SpA patients in some Asian countries.
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