Therapy goals
- Improvement of the symptomatology or alleviation of rheumatic symptoms.
- Reduce the process of joint remodeling or delay the ossification of the spine.
Therapy recommendations
The recommended therapy presented below applies to ankylosing spondylitis (AS; synonyms: ankylosing spondylitis, ankylosing spondylitis) and to all forms of axial spondyloarthritis (axSpA) and, therefore, to nonradiographic axial spondyloarthritis (nr-axSpA).
Therapy recommendations:
- Therapy for axSpA should be started with patient education, regular exercise, and physical therapy!
- Anti-inflammatory drugs (non-steroidal anti-inflammatory drugs, NSAIDs) for axial and peripheral manifestations [first-line therapy for axSpa].
- Predominant peripheral arthritis: sulfasalazine.
- Axial and peripheral manifestation: local glucocorticoid injections.
- Treatment refractory cases of ankylosing spondylitis [S3 guideline] (applies to axial and peripheral manifestations): a recommendation on whether to start with a TNF inhibitor or an IL-17 inhibitor cannot be made based on study data on efficacy on the axial skeleton and safety. Longer experience in clinical use exists for TNF inhibitors.
