If you’re one of the 2.4 million Americans living with ankylosing spondylitis (AS) or a related condition, you’re no stranger to stiff, painful joints that often hinder your movement and make doing simple, everyday tasks a challenge.
Although there is no cure for AS, there are many effective treatments and medications available that can reduce your pain and other symptoms, and possibly even slow or stop the condition’s progression.
Once you’re diagnosed with AS, it’s important to start treatment right away to slow progression of this condition and cut your chances of irreversible joint damage and loss of mobility. Often, a combination of medication, physical therapy and exercise and good posture habits can relieve pain and stiffness in your joints and spine, and delay complications down the road. Work with your doctor to decide what will work best for you and your particular symptoms.
4 Main Types of Medication Used to Treat AS
Today, many medicines are available to treat AS. Your doctor may recommend combining two or more drugs. Each medication has its own set of side effects and precautions, so talk to your doctor to figure out the best treatment plan for you.
These are the four main types of medications used to treat AS:
• Biologic agents
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used medications to control the inflammation, pain and stiffness of AS. Over-the-counter NSAIDs include aspirin, ibuprofen (Motrin, Advil, Nuprin) and naproxen (Aleve), while stronger prescription NSAIDs, including COX-2 inhibitors (Celebrex), are also available.
Because all NSAIDs can have serious side effects, it’s important that your doctor watches you closely if you’re taking these medications regularly.
Potential side effects: Gastrointestinal problems, from heartburn to ulcers and bleeding; high blood pressure and increased risk of heart attack and stroke.
Fast-acting corticosteroid medications, such as cortisone or prednisone, may be used when NSAIDs alone aren’t able to get potentially destructive inflammation under control. Corticosteroids are injected directly into the affected hip or knee joints – but never the spine – for temporary, quick relief. Due to harmful side effects, doctors use them for a short time span and in low dosages.
Potential side effects: Cataracts, weight gain, diabetes, brittle bones.
Often used to treat rheumatoid arthritis, Disease-Modifying Anti-Rheumatic Drugs (DMARDs) have had limited success in AS patients. The most commonly used DMARD for AS is sulfasalazine. It controls inflammation and swelling in smaller joints such as the knees, without compromising the immune system. Others include methotrexate, which may also be effective in controlling severe AS symptoms.
Potential side effects: Many DMARDs suppress the immune system, so watch out for a sore throat, coughing or a fever. Other side effects may include headaches, abdominal bloating, nausea, vomiting, bone marrow suppression, liver damage.
Biologic agents are a newer type of medication used to treat ankylosing spondylitis and related arthritis conditions. Currently, four biologics have been approved by the FDA to treat AS. They include adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade) and golimumab (Simponi).
Taken intravenously, these agents effectively block the inflammation that leads to pain, fatigue and other symptoms, and may even slow or stop progression of the condition. These drugs are often successful at relieving AS symptoms when NSAIDs and other treatments haven’t worked.
Potential side effects: Higher risk for serious infections, especially tuberculosis; neurological problems; congestive heart failure; rarely, cancer.
The future for treating AS is promising, as researchers continue to discover effective, new medications. You can successfully manage your AS symptoms and enjoy a healthy, happy and productive life. Work closely with your doctor and healthcare team to explore your options and develop a treatment plan that will work for you.
What treatments have been successful for you? Share your experience in the comment section below.