Management of ankylosing spondylitis

Abstract

Recently, the Assessment of SpondyloArthritis international Society (ASAS) and European League Against Rheumatism (EULAR) recommendations on the management of AS have been published, based on a thorough analysis of the available literature and on a meeting of spondyloarthritides (SpA) experts. These recommendations are shown in Figures 6.1 and 6.2 [54]. Non–drug approaches are part of the therapy at all stages of the disease. For the predominantly axial manifestation, the treatment options are limited to non–steroidal anti–inflammatory drugs (NSAIDs) as a kind of basic treatment, followed by tumour necrosis factor (TNF)–blocker therapy if this conventional treatment fails. If the clinical picture is dominated by peripheral symptoms such as arthritis or enthesitis, treatment with sulfasalazine and/or local steroid injection should be tried first before TNF blockers are considered.