Axial Spondyloarthritis (Ankylosing Spondylitis)

​Specialised and dedicated clinics that treat patients with Axial Spondyloarthritis may result in better outcomes. Treatment of Axial Spondyloarthritis is focused on alleviating symptoms of pain, stiffness and fatigue, and preventing worsening of the condition and complications such as inflammation of the eye. There is also a need to regain and maintain the mobility of the spine and reduce inflammation in the joints, digits and tendons of the upper and lower limbs.

• Medication
  NSAIDs (non-steroidal anti-inflammatory drugs) are important in reducing inflammation, pain and stiffness of the digits, joints and tendons in your upper and lower limbs. Other pain-relieving drugs may also be used.
  Depending on the joints involved and the severity of the condition, steroids and DMARDs (disease-modifying anti-rheumatic drugs) may be prescribed to reduce the inflammation of your joints. In patients who respond poorly to NSAIDs and DMARDs, you may be considered for biological therapy.
  Biologics are complex mixtures of proteins that target specific parts of the immune pathway to reduce inflammation. Currently available biological therapies for Axial Spondyloarthritis locally include anti-tumour necrosis factor (TNF) drugs, such as etanercept, adalimumab, golimumab and infliximab, as well as interleukin 17 inhibitors, such as secukinumab and ixekizumab. They are very effective in treating both the spinal and peripheral joint symptoms of Axial Spondyloarthritis. These drugs are injected subcutaneously (under the skin) or may require infusion in the hospital at regular intervals.
  However, biological treatment is expensive and not without side effects, including an increased risk for serious infections, e.g. development of active tuberculosis. Your doctor will discuss the cost and weigh the benefits and risks with you when considering treatment with biological therapies. Treatment with biological therapies are safe if monitored properly.
  
• Exercise
  Exercise, including stretching, helps reduce stiffness of the spine and limbs. Generally, swimming is recommended for all forms of arthritis. Other individualised physical therapies will also be recommended by the rheumatologist and physiotherapist. In order to be effective, all exercises need to be done regularly and on a long-term basis.