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
Department of Rheumatic & Immunologic Diseases
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.
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Elaine Husni, MD, MPH
Consulting Fees: AbbVie, Janssen, Lilly, Novartis, Pfizer, Regeneron, UCB Pharma
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Supported by an educational grant from Novartis Pharmaceuticals Corporation.