Best Treatments for Ankylosing Spondylitis

Q. I’ve been diagnosed with ankylosing spondylitis. Which treatments are recommended?

A. The American College of Rheumatology has released updated treatment guidelines for ankylosing spondylitis and nonradiographic axial spondyloarthritis. The guidelines cover the recommended drug and nondrug treatments, strategies for monitoring patients, managing related conditions, and considerations for surgical approaches.

The guidelines provide helpful guidance for treating active ankylosing spondylitis, stable ankylosing spondylitis, ankylosing spondylitis together with additional conditions such as advanced hip arthritis, severe kyphosis, acute iritis, inflammatory bowel disease, and non-radiographic axial spondyloarthritis.

For example, for patients with active ankylosing spondylitis, recommendations include the use of nonsteroidal anti-inflammatory drugs, tumor necrosis factor inhibitors when nonsteroidal anti-inflammatory drugs (NSAIDs) don’t work, physical therapy, and hip arthroplasty for patients with advanced hip arthritis. Tumor necrosis factor inhibitors monoclonal antibodies were recommended for patients who also have inflammatory bowel disease or recurrent iritis.

In this joint project by the American College of Rheumatology, the Spondylitis Association of America, and the Spondyloarthritis Research and Treatment Network, doctors and researchers developed the recommendations after reviewing studies that addressed 57 specific treatment questions and evaluating the quality of clinical evidence.

The treatment recommendations are voluntary and will provide a useful framework as you work with your rheumatologist to determine your best treatment plan.

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