Approved Treatments for Ankylosing Spondylitis
There is currently no cure for ankylosing spondylitis (AS), but there are approved medications available that can relieve symptoms of the disease.
Anti-tumor necrosis factor medications, also called TNF inhibitors, are a newer type of injected medication that can alleviate AS symptoms. TNF inhibitors prevent the TNF protein from causing inflammation and reduce inflammation that has already developed in the joints.
Doctors need to keep a close watch on the effects of anti-TNF medications as they are not suitable for everyone, and should be prescribed only if a person’s AS symptoms can’t be controlled with physiotherapy and NSAIDs.
Cimzia (certolizumab pegol) is an artificial antibody fragment engineered to treat adults with AS. It works to reduce joint swelling and tenderness, pain, and fatigue, and improve physical function. The therapy is available as a free-dried powder or a solution in a prefilled syringe.
Enbrel (etanercept) is an approved TNF inhibitor for the treatment of AS and to prevent joint damage caused by the disease. When Enbrel binds to TNF, it blocks its activity, thereby reducing inflammation and pain. It is administered via subcutaneous (under-the-skin) injection.
Cyltezo (adalimumab-adbm) is a type of therapy called a biological disease-modifying anti-rheumatic drug (DMARD). It is an approved Humira biosimilar but is not yet commercially available in the U.S. Cyltezo is administered as a subcutaneous injection from a pre-filled syringe.
Simponi (golimumab) is an approved therapy for AS that is available in two formulations, Simponi and Simponi ARIA. Simponi is given as a monthly injection, while Simponi ARIA is given via a 30-minute intravenous (into-the-vein) infusion every eight weeks.
Remicade (infliximab) is an approved treatment that works to reduce pain, stiffness and similar symptoms in patients with AS and other inflammatory conditions. It is administered by intravenous infusion. Two biosimilars to Remicade also have been approved: Ixifi and Remsima.
Interleukins signal immune cells to activate inflammation. Normally, interleukin-17 (IL-17) helps the body defend itself against infections. But high amounts of it can cause joint inflammation, bone erosion, and bone fusion in AS patients. IL-17 inhibitors block IL-17, reducing inflammation. Scientists have linked another signaling molecule, IL-23, to AS because it also tempers the production of IL-17.
Cosentyx (secukinumab) is an approved DMARD for the treatment of AS and non-radiographic axial spondyloarthritis. This type of therapy acts directly to modify the underlying cause of the condition by preventing, rather than just reducing, the inflammation. It is given by subcutaneous injection.
Taltz (ixekizumab) is an approved therapy designed to help alleviate arthritic pain and stiffness caused by inflammation. By decreasing IL-17A-directed inflammation, Taltz can significantly reduce AS symptoms, such as morning stiffness, spine or back pain, and fatigue. It is given via subcutaneous injection.
Janus kinase (JAK) inhibitors are intended to curtail an overactive immune system that leads to tissue damage in AS and other conditions. In cells, the JAK/STAT pathway is known to regulate the production of inflammatory mediators and has been associated with autoimmune diseases, conditions such as AS that are characterized by an attack of the immune system against the body’s own tissues.