The Role of the Family Practice Provider in the Diagnosis, Management, and Referral of Patients with Ankylosing Spondylitis




Ankylosing spondylitis (AS) affects up to 1.4% of Americans and is a chronic and severe type of spondyloarthritis (SpA) that primarily affects the axial skeleton, with symptoms of chronic back pain, stiffness, and progressive loss of spinal mobility. The diagnosis of AS may be delayed by up to 14 years, and if not adequately treated, AS can lead to substantial disability, including total fusion of the axial skeleton, and impaired quality of life. Tumor necrosis factor inhibitors (TNFis) were the first biologic agents approved for AS, but in some patients, the efficacy of TNFi therapy can wane over time, whereas others are unable to tolerate these medications. In 2016, secukinumab gained FDA approval as the first IL-17A inhibitor for AS, and in 2019, ixekizumab, another IL-17A inhibitor, received approval for AS. In addition, new clinical practice guidelines were published in October 2019, providing updated guidance on the evidence-based management of AS, including the roles of secukinumab and ixekizumab. Healthcare providers must be knowledgeable of the underlying disease, diagnostic approaches, guideline recommendations, current therapies, and when to refer to a rheumatologist in order to truly optimize outcomes for patients with AS.


Elaine Husni, MD, MPH
Vice Chair
Department of Rheumatic & Immunologic Diseases
Cleveland Clinic
Cleveland, Ohio


Release date: August 31, 2020
Expiration date: August 31, 2021
Estimated time to complete activity: 1.0 hour(s)



This educational activity is intended for family medicine practitioners, including primary care physicians, nurse practitioners, physician assistants, and other healthcare professionals involved in the management of patients with ankylosing spondylitis.


Upon completion of this educational activity, participants should be able to:

  • Review the epidemiology, etiology, and signs/symptoms of AS
  • Recognize the role of family practice in the timely diagnosis of AS
  • Apply current guideline recommendations to the management of AS
  • Evaluate the latest data on the efficacy, safety, and dosing/administration of newly-approved biologic therapies for AS
  • Integrate appropriate and early referral strategies for patients with AS

There are no fees for participating and receiving CME credit for this activity. During the period of August 31, 2020 through August 31, 2021, participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 75% or better.




Integrity Continuing Education is accredited with commendation by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Integrity Continuing Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education at (855) 835-4004 or


Integrity Continuing Education requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Elaine Husni, MD, MPH
Consulting Fees: AbbVie, Janssen, Lilly, Novartis, Pfizer, Regeneron, UCB Pharma

The Integrity Continuing Education, Inc. planners and managers have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc. and Novartis Pharmaceuticals Corporation do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


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The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.


Provided by Integrity Continuing Education, Inc.


Supported by an educational grant from Novartis Pharmaceuticals Corporation.


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