I’ve spent more time as my own lab rat, testing various ankylosing spondylitis treatments and diet than I’d like to admit. Sufferers of AS likely prefer to NOT have to think about it any more than we have to. Unfortunately, we don’t have that luxury.
Below, is my attempt to detail the different drugs available on the market right now to treat this arthritis.
For a disease so variable in its symptoms, the medical approach most doctors take is surprisingly uniform. When writing their prescriptions, rheumatologists appear to stick to three main medications:
Each has their own means of handling the inflammation you experience with ankylosing spondylitis. They also all have their own side effects you’ll want to be on the lookout for.
Shorthand for ‘non-steroidal anti-inflammatory drugs,’ these include ibuprofen, naproxen, indomethacin and phenylbutazone. Of those, ibuprofen tends to be the most often prescribed. Doctors consider these the first line of defense against ankylosing spondylitis associated inflammation.
When prescribed an NSAID, the major side effects to look out for are gastrointestinal in nature. Stomach ulcers are common for long-term users of these drugs. Other side effects include liver damage, kidney damage, heartburn, diarrhea and more.
These are are ‘disease-modifying antirheumatic drugs.’
Doctors prescribe these when more common anti-inflammatory medications like NSAIDs fail on their own. DMARDs treat the inflammation of joints while slowing the immune system’s attack on a patient’s body.
Methotrexate is a common prescription written from this group. Other DMARDs include plaquenil (hydroxychloroquine), azulfidine (sulfasalazine), minocine and arava.
Because DMARDs slow the immune system, the side effects tend to sound more intimidating. This means you’ll be more prone to infection and disease while taking them. Other side effects include severe birth defects, nausea, liver damage, hair loss and more.
The last group of prescription medicines are a relatively new addition for ankylosing spondylitis treatments: Biologics. These were first used in the late 1990s to treat AS. Biologics derive their name from their origin as medicine engineered from biological organisms. Medicines falling under this category include infliximab (brand name: Remicade), golimumab (brand name: Simponi), etanercept (brand name: Enbrel) and adalimumab (brand name: Humira).
Biologics are also known as ‘TNF inhibitors,’ short for ‘tumor necrosis factor-alpha.’ This is the second drug group targeting the immune system. They do so by disrupting an inflammation-inducing protein within the body. Unlike NSAIDs and DMARDs, these are only taken through injection and can be much more expensive for the patient.
Because biologics are so new, the long term effects are still in the testing phases. Possible side effects include susceptibility to infection, stomach pain, nausea, skin problems and more.
As more doctors are able to accurately diagnose this disease, ankylosing spondylitis treatments are advancing. For those of us suffering in the here and now, this advancement is important to be aware of.
After all, coming to your rheumatologist with even a basic understanding of your medical options can be a life changer.
If you think I missed something or are looking for a little clarification, don’t hesitate to leave a comment below.