Table of ContentsView AllTable of ContentsGuidelinesMedicationsResearchFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Guidelines
Medications
Research
Frequently Asked Questions
Currently, there is no cure forankylosing spondylitis, but recent research is offering new treatment options to manage the symptoms and slow the progression of the condition.
This article will cover new guidelines for treating and testing ankylosing spondylitis. It will also include alternative treatment options available to manage the symptoms.
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New Guidelines and Genetic Testing Lead to a Quicker Diagnosis
In 2019, the American College of Rheumatology developed a new set of guidelines for ankylosing spondylitis diagnosis and treatment. The goals of the new guidelines were to:
The guidelines give healthcare providers recommendations and guidance on using new medications and imaging (X-rays).
Genetic testing is one tool used in thediagnosis of ankylosing spondylitis. Genetic testing does not provide a firm confirmation or a complete diagnosis of the condition, however.
Researchers have found a variation in the HLA-B gene calledHLA-B27—which plays a part in the immune system—that is linked to ankylosing spondylitis. If someone has the HLA-B27 gene, it is not guaranteed they will have ankylosing spondylitis.
The association between ankylosing spondylitis and HLA-B27 varies significantly among ethnic and racial groups. In the White population in the United States, 95% of people with ankylosing spondylitis have the HLA-B27 gene variation. Whereas 80% of people from Mediterranean countries and 50% of the African American population with ankylosing spondylitis have HLA-B27.
Other gene variations linked to ankylosing spondylitis include ERAP1, IL1A, and IL23R. These genes also play a role in the immune system. Researchers do not know how these genes affect a person’s risk of developing ankylosing spondylitis.
New Medications
JAK Inhibitors
One of the newest medications available for ankylosing spondylitis is ajanus kinase (JAK) inhibitor. JAK inhibitors are used in people who do not find relief fromnonsteroidal anti-inflammatory drugs (NSAIDs)and are unable to take TNFi or IL-17 inhibitors.
TNF Inhibitors
Tumor necrosis factor inhibitors(TNFi) are part of the biologics medication class. These medications block excess tumor necrosis factor (TNF), which increases inflammation in the body. Medications that are TNFi include:
TNFi is given through an infusion or injection. This medication is prescribed when NSAIDs are ineffective and is the first choice of biologics for ankylosing spondylitis.
TNFis can increase the likelihood of developing infections and the risk of certain cancers like lymphoma (cancer of the lymphatic system) and skin cancer.
IL-17 Inhibitors
Interleukin-17 (IL-17) is a cytokine that tells the body to start the inflammatory process. When there is too much IL-17, it can hurt the body.
Like the other medications mentioned, IL-17 inhibitors increase the likelihood of infection. They have also been shown to increase the probability of developinginflammatory bowel disease.
IL-23 Inhibitors
Interleukin-23 (IL-23) is another cytokine that can cause inflammation in the body. The IL-23 inhibitorStelara(ustekinumab) is a biologic medication that blocks IL-23.
How Biologics Work for Ankylosing Spondylitis
Research on Alternative Treatments
People with ankylosing spondylitis may seek alternative treatments if conventional therapies do not relieve their symptoms. Alternative treatments should always be discussed with a healthcare provider to ensure there is no contraindication (reason for a person to not receive a particular treatment or procedure because it may be harmful) to current treatments.
Water Therapy
Water therapy (hydrotherapy) is a helpful treatment in managing ankylosing spondylitis symptoms. When someone is in the water, there is less stress on the joints, which can relieve pain. Other benefits of water therapy include:
A 2021 meta-analysis and systematic review found that water therapy helped ease pain and disease activity in those withankylosing spondylitis. However, it did not change spinal mobility or functional capacity.This still makes water therapy a good alternative when land therapy is not an option.
Physical Therapy
A physical therapist can help patients develop a safe and effective exercise and stretching routine to control the symptoms.
Summary
Ankylosing spondylitis is a type of spine arthritis with no known cure. There are several different treatments available to manage the symptoms of the condition. New research and medications are paving the way for better symptom control and improving quality of life.
A Word From Verywell
There are numerous medications available to people with ankylosing spondylitis. If one medication does not work, it does not mean that the whole class of medications will not be effective for you. Keep working with your healthcare provider to find the best medication regimen to manage your symptoms.
Frequently Asked QuestionsThere is no one medication that is most effective at treating ankylosing spondylitis. If NSAIDs are not managing the symptoms, the next step is a TNFi. A healthcare provider will help guide patients in finding the best medications for their symptoms.There is no known cure for ankylosing spondylitis. However, research is always revealing more information about the condition that aids in creating medications to help with AS symptoms.Medications are the mainstay treatment for ankylosing spondylitis. However, exercise and a healthy diet are integral parts to the whole treatment plan.
There is no one medication that is most effective at treating ankylosing spondylitis. If NSAIDs are not managing the symptoms, the next step is a TNFi. A healthcare provider will help guide patients in finding the best medications for their symptoms.
There is no known cure for ankylosing spondylitis. However, research is always revealing more information about the condition that aids in creating medications to help with AS symptoms.
Medications are the mainstay treatment for ankylosing spondylitis. However, exercise and a healthy diet are integral parts to the whole treatment plan.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ward MM, Deodhar A, Gensler LS, et al.2019 update of the American college of rheumatology/spondylitis association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis.Arthritis Rheumatol. 2019;71(10):1599-1613. doi:10.1002/art.41042Spondylitis Association of American.Diagnosis of ankylosing spondylitis.MedlinePlus.Ankylosing spondylitis.Spondylitis Association of America.JAK inhibitors: a new treatment option on the horizon for spondyloarthritis.Spondylitis Association of America.Medications used to treat ankylosing spondylitis and related diseases.National Axial Spondyloarthritis Society.Hydrotherapy.Liang Z, Fu C, Zhang Q, et al.Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis.Disabil Rehabil. 2021;43(7):895-902. doi:10.1080/09638288.2019.1645218Spondylitis Association of America.Exercise.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ward MM, Deodhar A, Gensler LS, et al.2019 update of the American college of rheumatology/spondylitis association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis.Arthritis Rheumatol. 2019;71(10):1599-1613. doi:10.1002/art.41042Spondylitis Association of American.Diagnosis of ankylosing spondylitis.MedlinePlus.Ankylosing spondylitis.Spondylitis Association of America.JAK inhibitors: a new treatment option on the horizon for spondyloarthritis.Spondylitis Association of America.Medications used to treat ankylosing spondylitis and related diseases.National Axial Spondyloarthritis Society.Hydrotherapy.Liang Z, Fu C, Zhang Q, et al.Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis.Disabil Rehabil. 2021;43(7):895-902. doi:10.1080/09638288.2019.1645218Spondylitis Association of America.Exercise.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ward MM, Deodhar A, Gensler LS, et al.2019 update of the American college of rheumatology/spondylitis association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis.Arthritis Rheumatol. 2019;71(10):1599-1613. doi:10.1002/art.41042Spondylitis Association of American.Diagnosis of ankylosing spondylitis.MedlinePlus.Ankylosing spondylitis.Spondylitis Association of America.JAK inhibitors: a new treatment option on the horizon for spondyloarthritis.Spondylitis Association of America.Medications used to treat ankylosing spondylitis and related diseases.National Axial Spondyloarthritis Society.Hydrotherapy.Liang Z, Fu C, Zhang Q, et al.Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis.Disabil Rehabil. 2021;43(7):895-902. doi:10.1080/09638288.2019.1645218Spondylitis Association of America.Exercise.
Ward MM, Deodhar A, Gensler LS, et al.2019 update of the American college of rheumatology/spondylitis association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis.Arthritis Rheumatol. 2019;71(10):1599-1613. doi:10.1002/art.41042
Spondylitis Association of American.Diagnosis of ankylosing spondylitis.
MedlinePlus.Ankylosing spondylitis.
Spondylitis Association of America.JAK inhibitors: a new treatment option on the horizon for spondyloarthritis.
Spondylitis Association of America.Medications used to treat ankylosing spondylitis and related diseases.
National Axial Spondyloarthritis Society.Hydrotherapy.
Liang Z, Fu C, Zhang Q, et al.Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis.Disabil Rehabil. 2021;43(7):895-902. doi:10.1080/09638288.2019.1645218
Spondylitis Association of America.Exercise.
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