Medications to Treat Ankylosing Spondylitis

4 different medications and how one or more may help you manage your ankylosing spondylitis pain and symptoms

Medications may help reduce and manage the symptoms of ankylosing spondylitis (AS), so they will likely have a place in your treatment plan. Though medicine cannot cure your AS, it may reduce your pain and enable you to more fully participate in the activities you enjoy.

This article describes the following types of drugs and biologics you may be prescribed to manage your ankylosing spondylitis-related back and joint pain:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
  • Corticosteroids
  • Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Biologics (TNF-blocking Agents)

medication in a woman's hand

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs reduce pain and inflammation, and are the most common type of drug therapy for AS. This class of medication is often part of the first line of treatment for the disease.

  • Examples: Ibuprofen, piroxicam, and naproxen
  • Over the counter or prescription only? Most NSAIDs are available over the counter, but some (eg, COX-2 inhibitors) require a prescription.
  • Key considerations: You may need to take NSAIDs for a few weeks before you notice any measurable improvement. Also, you will need to be monitored by your doctor when you use NSAIDs for long periods. NSAIDs have potentially serious side effects, including causing stomach problems and high blood pressure.

Your doctor may prescribe a corticosteroid if the NSAID you’re taking isn’t providing enough relief of your inflammation.

  • Examples: Methylprednisolone and cortisone
  • Over the counter or prescription only? Prescription only
  • Key considerations: Corticosteroids for AS may be taken by mouth or injected into your joints (such as a sacroiliac joint or hip joint—but not joints in your spine). These medications are typically used on a short-term basis to provide quick, temporary relief during flare ups.

Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs control inflammation, and may help stop or slow the progression of AS.

  • Examples: Sulfasalazine and methotrexate
  • Over the counter or prescription only? Prescription only
  • Key considerations: Researchers are still trying to understand the extent of DMARDs’ ability to stop or slow AS disease progression. DMARDs are not quick fixes—they work slowly and must be taken exactly as your doctor instructs.

Biologics (TNF-blocking Agents)
Biologics are a newer generation of DMARDs and may be used if traditional DMARDs don’t reduce symptoms of ankylosing spondylitis. These genetically engineered drugs block the tumor necrosis factor-alpha (TNF-α) protein to reduce inflammation.

  • Examples: Adalimumab, certolizumab, etanercept, golimumab, and infliximab
  • Over the counter or prescription only? Prescription only
  • Key considerations: You may receive a biologic via intravenous infusion (IV) or injection. If you don’t respond to one type of biologic, that doesn’t mean you won’t respond to another formulation, so your doctor may prescribe a different biologic. Symptoms should improve within a few weeks of starting biologic drug treatment.

Medications and Your Ankylosing Spondylitis Treatment Plan
With many medications available to help you manage your ankylosing spondylitis (AS) symptoms, your doctor will develop the appropriate regimen for you. Make sure you talk to your doctor about all medicines you take—even over-the-counter drugs, vitamins, herbal products, and supplements—so he or she can create a plan that safely and effectively addresses your AS symptoms and pain. Once you’ve been prescribed medication, take it exactly as prescribed (even when/if you’re feeling well). Also, talk to your doctor if symptoms aren’t going away or new ones have emerged.

Updated on: 03/14/17
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