Diagnosis Treatment & Management of Ankylosing Spondylitis
Drug Therapies for Ankylosing Spondylitis
A wide variety of drug therapies are available for the treatment of AS. The key to success is matching the degree of illness with the corresponding drug. Why not treat AS patients with all the drug categories?
Each drug category has associated side effects. A patient wants to limit those exposures to a minimum. Essentially, patients want to take the appropriate number of medicines and not one extra.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs, or aspirin-like drugs possess abilities to decrease pain, fever, and inflammation. They are anti-inflammatory and pain-relieving when given in larger doses long term. In AS, NSAIDs decrease spine stiffness and pain. In a significant number of AS patients, NSAIDs are adequate by themselves to control disease symptoms and improve function.
There is also clinical evidence that NSAIDs may slow the calcification of spine structures when taken on a chronic basis. A specific type of NSAID is the cyclo-oxygenase-2 inhibitor. Cyclo-oxygenase -2 enzyme produces cell messengers (cytokines) that initiate and sustain inflammation in tissues. COX-2 inhibitors prevent the production of these cytokines while having no effect on the products of COX-1 enzyme that is necessary for the normal function of the stomach and kidney.