METHODS AND RESULTS

Patients with severe AS were treated with 6 monthly intravenous pulses of pamidronate, receiving 30 mg for the first infusion and 60 mg subsequently. The Bath AS Disease Activity Index (BASDAI) and the Bath AS Metrology Index (BASMI) scores were recorded, and C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measured at each visit. Fifteen patients participated (13 male, mean age 44). Mean disease duration was 14.8 years. All patients were receiving non-steroidal anti-inflammatory drugs; two were also receiving sulfasalazine, one methotrexate, and one azathioprine. No patients were currently receiving an oral bisphosphonate. Four patients had a history of uveitis, two psoriasis, two inflammatory bowel disease, and eight peripheral arthritis.