Diagnosis Treatment & Management of Ankylosing Spondylitis

• Cosentyx(secukinumab) is an anti-IL-17 monoclonal antibody that blocks the effects of IL-17 leading to an improvement in IL-17 associated symptoms.
• **Taltz (**ixekisumab) is an anti IL-17 monoclonal antibody that blocks the effects of IL-17.

These agents can be effective in those individuals who have failed one or more TNF inhibitors. Factors that identify those individuals who are more responsive to one class of biologic agent versus another are being investigated but are not available for clinical use at this time.

Side effects associated with the use of IL-17 inhibitors include an increased risk of infections. Another very small risk is the development or worsening of inflammatory bowel disease.

Surgical Therapies for Ankylosing Spondylitis

Surgical therapies for AS are more commonly used for the peripheral joints than for the spine. At times the spine can become so brittles that it will fracture. The neck is the most common location for this fracture. Stabilization of the spine is necessary to prevent damage to the spinal cord.

Peripheral joints can be damaged to the degree of requiring a replacement. The hips and shoulders are the most commonly affected peripheral joints. The decision about joint replacement must be done in the setting of spine involvement and how the replacement will result in improved function.