Answering Your Questions About the Potential Side Effects of Ankylosing Spondylitis Medications
Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and joints. In managing this condition, understanding the available treatment options and their potential side effects is crucial.
The first-line treatment for ankylosing spondylitis is a combination of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and physical therapy. This approach helps alleviate symptoms and, importantly, limits joint damage.
If the initial treatment proves ineffective, doctors may prescribe TNF inhibitors such as adalimumab (Humira) or infliximab (Remicade). These medications help block inflammation and reduce symptoms, lowering the risk of lasting joint damage. However, it's essential to note that TNF inhibitors may not be safe for people with certain medical conditions, such as congestive heart failure or hypersensitivity to this type of medication.
Physical therapy exercises and certain lifestyle changes can also benefit physical function. However, physical therapy and lifestyle changes alone are not enough to stop the immune reaction that causes inflammation and joint damage in ankylosing spondylitis.
When biologic medications such as TNF inhibitors and IL-17 inhibitors stop working or do not work well, JAK inhibitors provide a treatment option. JAK inhibitors are among the newest treatment options for ankylosing spondylitis, blocking the action of certain kinds of tyrosine kinases to help manage inflammation.
Methotrexate is another medication used in the treatment of ankylosing spondylitis. While it can be effective, it carries a risk of serious reactions such as tumor lysis syndrome, increased risk of some cancers (blood or skin), and joint pain or swelling. Close monitoring is required due to its potential serious effects.
NSAIDs like Celecoxib (Celebrex) are also commonly used. They can cause abdominal pain, diarrhea, gas, headache, fluid retention causing swelling, increased blood pressure, potential kidney and liver issues, and rare but serious skin reactions such as Stevens-Johnson syndrome.
It's important to remember that changing between these medications can lead to overlapping side effects related to the new drug’s mechanism and immune impact. Common mild-to-moderate side effects often improve as the body adjusts, but serious side effects require medical attention.
Patients should monitor for symptoms such as persistent injection site pain, unusual infections, severe abdominal pain, changes in urine, swelling, or new rashes, and report these promptly to their healthcare provider. Each medication has specific warnings, so close medical supervision during medication changes is essential.
In some cases, a doctor may also prescribe corticosteroid injections or sulfasalazine for symptoms in peripheral joints.
[1] Reference for Humira side effects: https://www.medicines.org.uk/emc/medicine/10432 [2] Reference for Methotrexate side effects: https://www.medicines.org.uk/emc/medicine/1413 [3] Reference for Celecoxib side effects: https://www.medicines.org.uk/emc/medicine/10082 [4] Reference for Stevens-Johnson syndrome: https://www.nhs.uk/conditions/stevens-johnson-syndrome/ [5] Reference for increased cancer risk with Humira: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-stats-figures/statistics-by-cancer-type/humira-and-risk-of-cancer
- Established treatment for ankylosing spondylitis typically includes a combination of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and physical therapy, helping alleviate symptoms and minimize joint damage.
- If initial treatment is not effective, doctors may consider TNF inhibitors like adalimumab (Humira) or infliximab (Remicade) as an alternative, as these medications help reduce symptoms and lower the risk of joint damage.
- However, it is essential to keep in mind that TNF inhibitors may not be suitable for individuals with certain medical conditions, such as congestive heart failure or hypersensitivity to this type of medication.
- Physical therapy exercises and lifestyle changes can enhance physical function, but they alone are not sufficient to halt the immune reaction causing inflammation and joint damage in ankylosing spondylitis.
- When biologic medications like TNF inhibitors and IL-17 inhibitors are no longer effective or do not work well, JAK inhibitors can serve as a treatment option, blocking the action of certain tyrosine kinases to manage inflammation.
- Methotrexate is another medicine used in the treatment of ankylosing spondylitis, although it carries a risk of significant reactions such as tumor lysis syndrome, increased risk of some cancers (blood or skin), and joint pain or swelling.
- NSAIDs like Celecoxib (Celebrex) are also commonly used, but they can cause side effects such as abdominal pain, diarrhea, gas, headache, fluid retention causing swelling, increased blood pressure, potential kidney and liver issues, and rare but serious skin reactions such as Stevens-Johnson syndrome.
