Diagnosis Treatment & Management of Ankylosing Spondylitis
Anti-Tumor Necrosis Factor Inhibitors (TNFi)
Cell messenger or cytokines, are released by cells to initiate a variety of functions. An inflammatory cytokine, TNF is associated with the clinical manifestations of AS. TNF is associated with fatigue, joint swelling, stiffness, and pain.
A decrease in the production of TNF, or removal from the blood stream can result in a decrease in disease-associated complaints. However, the total removal of TNF can be associated with an increased risk of infection.
The goal of therapy is to obtain a physiologic level of TNF. There are a number of ANTI-TNF therapies available for the treatment of AS including:
- Enbrel (entarnercept) is a soluble receptor for TNF injected weekly.
- Humira (adalimumab) is a fully human anti-TNF monoclonal antibody administered by injection every 2 weeks.
- Simponi (golimumab) is a fully human anti-TNF monoclonal antibody that is injected monthly.
- Cimzia (certolizumab) is an anti-TNF partial antibody connected to polyethylene gycol that prolongs the effect of the antibody that is injected every 4 weeks
- Remicade (infliximab) is a monoclonal directed against TNF that is administered intravenously every 4 to 8 weeks.