Medical management of ankylosing spondylitis.
In the following literature review the authors consider the available evidence for the medical management of patients with ankylosing spondylitis (AS), and they critically assess current treatment guidelines. Medical therapy for axial disease in AS emphasizes improvement in patients' pain and overall function. First-line treatments include individualized physical therapy and nonsteroidal antiinflammatory drugs (NSAIDs) in conjunction with gastroprotective therapy. After an adequate trial of therapy with two NSAIDs exceeding 3 months or limited by medication toxicity, the patient may undergo tumor necrosis factor-alpha blockade therapy. Response should occur within 6-12 weeks, and patients must undergo tuberculosis screening. Evidence does not currently support the use of disease modifying antirheumatic drugs, corticosteroids, or radiotherapy in AS.
Khalessi
Alexander A
AA
Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA. khalessi@usc.edu
Oh
Bryan C
BC
Wang
Michael Y
MY
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D007155:Immunologic Factors