title: An overview of investigational new drugs for treating ankylosing spondylitis.
abstract: BACKGROUND
  Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic condition. Pharmacological treatment relies on nonsteroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs (in case of peripheral involvement) and anti-TNF agents in case of inadequate response. To date, there are no alternate options, and about 30% of the patients do not adequately respond to anti-TNF therapy.
  
  
  METHODS
  This overview is based on recent publications and programmed studies. The author provides the reader with an overview of AS, its current management and provide details of novel insights into the disorder. From there, the authors highlight novel treatments under investigation before providing their expert opinion on the field.
  
  
  CONCLUSIONS
  The first results with biodrugs targeting the IL-23/Th17 pathway are encouraging, and secukinumab will likely be available in the forthcoming years to treat AS. Other targets may be evaluated in this axis. The author believes that additional head-to-head studies are needed find the place of these new drugs in AS treatment strategies. Further studies are also needed to better evaluate their long-term outcome and safety.
authors.affiliation: a Rheumatology , Université de Franche-Comté , Besançon , France.|b Department of Rheumatology , University Teaching Hospital, CHRU de Besançon , Besançon , F-25030 Besançon , France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D015195:Drug Design; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D053759:Interleukin-23 / Q000276:immunology; D058990:Molecular Targeted Therapy; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D058504:Th17 Cells / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D015507:Drugs, Investigational; D053759:Interleukin-23; D014409:Tumor Necrosis Factor-alpha; C555450:secukinumab
keywords: IL-17; IL-23; ankylosing spondylitis; apremilast; secukinumab; spondyloarthritis; tofacitinib; ustekinumab