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Neurology, Ophthalmology, Cardiology, Oncology, Obesity, Endocrinology, Vascular surgery - Causes, Symptoms, Diagnosis, Treatment, description of the disease.

Saturday, 08.08.2020, 06:47
Main » Vertebrology » Treatment of ankylosing spondylitis 
Treatment of ankylosing spondylitis

Treatment of ankylosing spondylitis is to provide drug therapy aimed at eliminating inflammation and / or suppress the immune system. In addition, using physical therapy and exercise therapy.

Among the main drugs used to treat ankylosing spondylitis, emit:
  • Nonsteroidal anti-inflammatory drugs
  • Steroidal anti-inflammatory drugs
  • Drugs that suppress the immune system
  • Biological means

Nonsteroidal anti-inflammatory drugs

It's drugs that are widely used in the treatment of many inflammatory joint disease and other systemic inflammatory diseases. Their mechanism of action lies in the fact that they block the body's substances that mediate inflammation - prostaglandins. For all of them are typical side effects such as irritation of the gastrointestinal tract (which is manifested by abdominal pain, nausea, vomiting, diarrhea and even ulcers and stomach bleeding), blood thinners (excessive bleeding that appears) and complications from kidney disease.

Steroidal anti-inflammatory drugs

These drugs belong to the hormone. They eliminate the effect of inflammation is that they suppress the immune system, which is responsible for inflammation. These drugs may be administered orally or by injection, intramuscular or intra. In this treatment is usually steroids should be as short as they are characterized by side effects.

Among the side effects of steroidal anti-inflammatory drugs are marked:
  • Osteoporosis (leaching from the bones of calcium salts)
  • Glaucoma,
  • Cataract,
  • The change of mood,
  • Increased blood sugar levels,
  • Obesity in the face,
  • Swelling and fluid retention in the body,
  • Ulcers of the stomach.

Drugs that suppress the immune system (immunosuppressive)

These medications include such as azathioprine, cyclosporine, gold salts (ridaura, solganal), penicillamine, and sulfasalazine. The mechanism of action of these drugs is to suppress the immune system. They apply only when the course of nonsteroidal antiinflammatory drugs was ineffective. Other drugs in this group for the treatment of ankylosing spondylitis do not apply. Among the side effects of immunosuppressive agents may be noted the toxicity to bone marrow - the main hematopoietic organ, as well as complications of the kidneys and liver.


The drug is contraindicated in: pregnant women, patients allergic to azathioprine, suffering from alcoholism, dysfunction of the bone marrow. Usually, azathioprine, taken orally three times a day. It is better to take it with food to reduce irritating to the stomach. Not recommended for use with other drugs azathioprine immunosuppressive group, as this increases the risk of infectious complications.


The drug is not recommended for patients who are undergoing so-called PUVA therapy, or irradiation with UV rays, since it increases the risk of skin cancer. In addition, it is contraindicated in patients with: an allergy to cyclosporine, renal dysfunction, uncontrolled hypertension, cancer, infectious diseases, immunodeficiency (HIV). Cyclosporine is used orally. Fatty food reduces its absorption, while the milk is slightly increased it. Grapefruit juice increases the concentration of cyclosporine in the blood, increasing its side effects. Also, he cyclosporine may increase the risk of kidney and muscle toxicity of drugs that lower cholesterol (statins).

The following drugs reduce levels of cyclosporine in the blood:

Anticonvulsants: carbamazepine, phenytoin and phenobarbital.

TB drugs: isoniazid, rifampicin.

The following drugs increase levels of cyclosporine in the blood:
Antibiotics: azithromycin, clarithromycin, erythromycin (macrolide drugs), and gentamicin.
Antifungals: ketoconazole, itraconazole, ketoconazole, fluconazole, amphotericin B.
Antiviral drugs: Zovirax.
Drugs for treatment of heart disease: verapamil, nifedipine (calcium channel blockers).

Gold salts

Preparations are contraindicated gold:

  • Allergies to other drugs of heavy metals
  • Severe colitis
  • Fibrotic lung disease
  • Exfoliative dermatitis
  • Diseases of the bone marrow
  • Diseases of the blood

Today, gold is rarely used drugs for the treatment of ankylosing spondylitis. Do not use salt at the same time gold medications that suppress bone marrow function. Among the major side effects of gold salts can be noted a skin rash and irritation, anorexia, stomatitis, diarrhea, infection of the eye, toxic effects on the kidneys, lungs, bone marrow.


Products in this group include such as etanercept and infliximab. They are antagonists of tumor necrosis factor (TNF). Their effect is that they suppress the main factors that are responsible for inflammation.

Contraindication to this drug is: allergy medication, sepsis, tuberculosis. Etanercept is used 1 - 2 times a week by injection. In the application of immunosuppressive drugs with others may increase the risk of lowering blood cells. In addition, immunization with vaccines against etanercept may be ineffective.

The drug should not be used in patients with heart failure and impaired renal function. Among the side effects can include:

Pain, swelling and redness at the injection site

  • Fever
  • Rash
  • Cold symptoms
  • Abdominal pain
  • Nausea
  • Vomiting.

It should be noted that the most effective treatment for ankylosing spondylitis in the early stages, however, this stage is very difficult to determine, since it does not appear in the X-ray diffraction.

Drugs that suppress the immune system, common in the treatment of inflammation of the joints, not related to the spine. For the treatment of inflammation of joints of the spine, they are ineffective. The ineffectiveness of non-steroidal anti-inflammatory drugs in patients with a predominance of pain in the joints of the spine are recommended Biologicals - tumor necrosis factor. These drugs are usually effective in the treatment of spondylitis.

Steroid drugs are also effective in eliminating arthritis of spine, but they can not be used for a long time, since they are characterized by side effects.

It is important to maintain the correct posture for the prevention of spinal curvature. It is always recommended where possible to keep your back straight. To sleep better on a hard surface. It is recommended swimming. It is necessary to restrict the activities and field, but it is recommended aerobics.

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