Fast Five Quiz: Ankylosing Spondylitis Management

Herbert S. Diamond, MD

Disclosures

June 29, 2020

NSAIDs are the most commonly used class of medication to reduce the pain and decrease inflammation associated with AS. NSAIDs should be given in full anti-inflammatory doses. Continuous treatment with NSAIDs has been suggested to reduce radiographic progression in AS.

Oral corticosteroids are occasionally helpful in controlling AS symptoms; however, they should be used only for short-term management because they have a high risk for adverse effects. No evidence has shown that corticosteroids alter the outcome of the disease, and these agents are known to increase the tendency toward spinal osteoporosis.

TNF alpha antagonists are indicated after NSAID therapy has failed and have been shown to be very effective in the treatment of AS. They have a fairly rapid onset of action (2 weeks) and have been shown to reduce the inflammatory activity of spinal disease as assessed with MRI.

Secukinumab and ixekizumab both target proinflammatory cytokine interleukin 17A (IL-17A) and have been approved by the US Food and Drug Administration for the treatment of AS. IL-17A is a naturally occurring cytokine that is involved in normal inflammatory and immune responses.

Learn more about the pharmacologic treatment of AS.

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