For Ankylosing Spondylitis (AS) not controlled by first-line NSAIDs and exercise, second-line treatments primarily involve Tumor Necrosis Factor (TNF) inhibitors (like adalimumab, infliximab, etanercept) or, in some cases, conventional DMARDs (like sulfasalazine), with newer options including IL-17 inhibitors (secukinumab, ixekizumab) and JAK inhibitors (upadacitinib, tofacitinib) used if anti-TNF agents are ineffective or unsuitable.
July 18, 2025
A new peer-reviewed study published in Arthritis & Rheumatology suggests that ivarmacitinib, a new medication known as a selective JAK1 inhibitor, may be a promising treatment for people with active ankylosing spondylitis (AS). The study was a randomized, double-blind clinical trial.
NSAIDs are the most commonly prescribed drugs for a disease similar to AS called nonradiographic axial spondyloarthritis (nr-axSpA). Both prescription and over-the-counter NSAIDs appear safe up to 20 weeks of pregnancy, but may cause serious kidney problems in a fetus if taken longer.
Common ankylosing spondylitis GI symptoms include: Bloating. Flatulence (gassiness) Diarrhea or constipation.
Monoclonal antibody treatment
Monoclonal antibodies, such as secukinumab and ixekizumab, may be offered to people with AS who do not respond to NSAIDs or anti-TNF medicine, or as an alternative to anti-TNF medicine. This type of treatment works by blocking the effects of a protein involved in triggering inflammation.
New Treatment Approved for Ankylosing Spondylitis: FDA OKs First JAK Inhibitor, Tofacitinib. The U.S. FDA has approved a new medication to treat ankylosing spondylitis (AS) – tofacitinib, known as Xeljanz or Xeljanz XR.
Stage 4 is the last stage of ankylosing spondylitis (AS). During this phase, AS may cause fusion of the vertebrae in the spine, significantly reducing spinal flexibility and range of motion.
HUMIRA Dosing for Ankylosing Spondylitis
The recommended dose is 40 mg every other week. Always follow your doctor's instructions about when and how often to take HUMIRA. HUMIRA is given by an injection under the skin. Your first dose of HUMIRA must be given under the supervision of a health care professional.
Ankylosing spondylitis can cause issues with the aorta. The aorta is the largest artery in the body. When the aorta gets inflamed, it can swell and change the shape of the aortic valve in the heart.
HLA-B27 associated spondyloarthropathies are associated with an altered intestinal microbiota and bowel inflammation.
Flying can be exhausting, and with a disease like ankylosing spondylitis you may experience increased symptoms like fatigue, pain, inflammation, and lower immunity. Knowing this in advance can empower you to prepare well for a successful flight and trip.
IV infusion for ankylosing spondylitis involves administering medication through an infusion pump that drips the medication into a catheter to a syringe and through a hollow needle into the patient's bloodstream. IV infusion therapy options for ankylosing spondylitis include Simponi Aria and Remicade.
A positive test means HLA-B27 is present. It suggests a greater-than-average risk for developing or having certain autoimmune disorders. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.
Illness and death
According to his father, Biden was diagnosed with ankylosing spondylitis in 2001 after returning from service in Kosovo.
The therapy that was used to treat this disease previously could only alleviate the symptoms of inflammation. A new drug, i.e. seniprutug, was developed by the biotechnological company "BIOCAD" together with a group of scientists from the Pirogov Russian National Research Medical University.
Biologic therapy can only be prescribed by a consultant rheumatologist. Your GP cannot offer it to you. If you are not under the care of a rheumatologist do ask your GP to refer you.
It's estimated 8 in every 100 people in the general population have the HLA-B27 gene variant, but most do not have AS. It's thought having this gene variant may make you more vulnerable to developing AS. The condition may be triggered by 1 or more environmental factors, although it's not known what these are.
Everyone with ankylosing spondylitis experiences a unique combination of symptoms. Lower back pain due to sacroiliitis (painful inflammation in your sacroiliac joints) is the most common AS symptom. The pain can spread (radiate).
All in the Family
The most common type of SpA is axial spondyloarthritis (axSpA), a term that covers both ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA).
IL-17 inhibitors used to treat ankylosing spondylitis include secukinumab (Cosentyx), ixekizumab (Taltz) and bimekizumab (Bimzelx). JAK inhibitors available to treat ankylosing spondylitis include tofacitinib (Xeljanz) and upadacitinib (Rinvoq).
For long-term treatment, biologics are generally considered safer than prolonged steroid use. While steroids work quickly to reduce inflammation, they can cause serious side effects when used long-term, including: Bone loss and increased fracture risk. Weight gain and swelling.
Neurological complications and symptoms of ankylosing spondylitis
Symptoms of the early stage may include lower back stiffness and pain, while those of the progressive stage can affect other parts of the body. A sign of the late stage involves the fusion of some of the bones in the spine.
HLA-B27 positivity alone is not life‑threatening. Most carriers never develop disease, but it increases risk for inflammatory conditions (e.g., ankylosing spondylitis, uveitis) that can cause chronic pain, functional problems, and rare complications if untreated. Early diagnosis and treatment lower risks.
X-ray Changes
A “bamboo spine” is the typical x-ray finding in the later stages of ankylosing spondylitis, where there is fusion of the sacroiliac and spinal joints. X-rays in ankylosing spondylitis can show: Squaring of the vertebral bodies. Subchondral sclerosis and erosions.