Medicine for Ankylosing Spondylitis (AS)

Medicine for Ankylosing Spondylitis (AS).  After being diagnosed in time and receiving professional and standardized treatment, tonic is able to control the condition, improve the prognosis, and finally achieve the goal of rehabilitation.
　　
Ankylosing spondylitis (AS) is a chronic inflammatory disease, which can be accompanied by various symptoms of joints and extra-articular, resulting in inconvenience or disability of patients, causing great harm to patients. Many patients must be very looking forward to it. There is a “magic medicine” that can effectively and completely cure rigidity.

However, it is disappointing that the current clinical treatment of tonic can not achieve a complete cure. Of course, the so-called “magic medicine” does not exist.

However, patients with rigid rigidity do not need to be discouraged. If rigid rigidity can be diagnosed in time and receive professional and standardized treatment, it can achieve the purpose of controlling the disease, improving the prognosis, and ultimately achieving the goal of rehabilitation.

Generally speaking, our treatment of rigidity is mainly through comprehensive treatment methods such as non-drugs, drugs, alternative medicine, surgery, etc., to relieve pain and stiffness symptoms, improve joint deformity or damage, and improve and restore the normal activities of limbs and joints to improve and Improve the quality of life of patients.

Individualized treatment needs to assess the patient’s joint function, disease activity, patient’s age, gender, occupation, family responsibilities, drug costs, which drugs have been used before, and how effective the treatment is. It usually needs to be formulated based on the specific patient’s condition and outpatient situation The corresponding treatment plan and medication standards, etc.

However, individualized treatment is also based on certain principles. So today, we will discuss common drug treatments for spondyloarthritis/ankylosing spondylitis from the perspective of overall treatment principles.

What are the commonly used drugs for tonic treatment?

1. Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs commonly used in rheumatology and immunology include celecoxib, methotrexate, leflunomide, glucocorticoids, etoricoxib, meloxicam, diclofenac sodium and so on. Common inflammatory mediators include prostaglandins, interleukins and tumor necrosis factor, etc. Non-steroidal anti-inflammatory drugs relieve these inflammatory mediators, thereby inhibiting inflammation and reducing pain. During the acute and remission phases of ankylosing spondylitis, these drugs can be used to relieve joint pain and stiffness, so as to restore the patient’s normal walking and other activities.

Of course, in order to avoid the side effects of drugs, it is necessary to combine the patient’s liver and kidney function, gastrointestinal and cardiovascular disease history, and select the drugs individually.

2. Biological agents

Biological agents commonly used in rheumatology and immunology include tumor necrosis factor inhibitors, interleukin-1 antagonists, interleukin-6 antagonists, CD20 monoclonal antibodies and so on. However, at present, the most widely used and the most effective biological agent in the treatment of ankylosing spondylitis is tumor necrosis factor inhibitors, and infliximab, adalimumab and etanercept are commonly used in China.

Because tumor necrosis factor is a substance that can cause hemorrhage and necrosis of a variety of tumors. Under normal circumstances, the content of tumor necrosis factor in human tissues and body fluids is very low. However, in patients with trauma, infection, tumor and autoimmune diseases, the content of this factor is elevated to varying degrees, which proves that tumor necrosis factor may be involved in the acute inflammatory response of ankylosing spondylitis.

Therefore, by inhibiting tumor necrosis factor, biological agents can achieve the effect of relieving the condition and improve the inflammatory response at the joints, especially for severe symptoms, high levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), nuclear magnetic resonance shows inflammatory or In patients with erosive lesions, tumor necrosis factor inhibitors are more effective.

Most patients in the active phase can obtain significant relief within 12 weeks of adequate treatment. For patients who relapse after stopping the drug, it is still effective to use it again or increase the dose.

3. Anti-rheumatic drugs to improve the condition

As we all know, ankylosing spondylitis and rheumatoid arthritis are autoimmune diseases, so can rheumatoid drugs be used to treat ankylosing spondylitis?

The answer is yes, but there are differences in treatment. Non-steroidal anti-inflammatory drugs and biological agents can be used to treat rheumatoids, but anti-rheumatic drugs that improve the condition are different in the treatment of rigidity and rheumatoids.

Although no anti-rheumatic drugs to improve the condition of the disease have been proven to be effective for the radiological progress and natural course of the patient with rigidity, a large number of literatures show that anti-rheumatic drugs that improve the condition of the disease have other disease evaluation indicators for axial spondyloarthritis. Obvious improvement effect.

Sulfasalazine is a traditional medicine for the treatment of ankylosing spondylitis. It can be decomposed into 5-aminosalicylic acid in the intestine to play an anti-inflammatory and immunosuppressive effect. It has a wide range of clinical applications.

The drug has been internationally recognized for the treatment of peripheral joint symptoms, but there is still much controversy about its effect on axial joint disease. Thalidomide can inhibit the production of tumor necrosis factor by monocytes, and has shown a good therapeutic effect on patients with rigidity. In a clinical study compared with sulfasalazine, the efficacy of the two is equivalent.

Leflunomide can also improve low back pain and morning stiffness in patients with rigidity, reduce the number of painful joints, and decrease the red blood cell sedimentation rate and C-reactive protein. But it has no obvious effect on CT of sacroiliac joint.

Because leflunomide has a low incidence of gastrointestinal reactions and patients are easily tolerated, leflunomide is a better choice for patients with rigidity who are allergic to sulfa, intolerant to sulfasalazine, or have poor efficacy.

In addition to drug treatment, non-drug treatment is also used clinically to maintain the stability of the disease and reduce the recurrence and aggravation of symptoms, so as to cooperate with drug treatment to achieve early recovery of patients.

• Such as maintaining a happy and relaxed mental state;
• Perform appropriate and simple exercises under the guidance of a doctor to maintain the best position of the spinal joints, strengthen the paravertebral muscles and increase lung capacity;
• Reduce the posture of flexion deformity of the spine joints, avoid the pillows from being too high, and try to keep the chest upright in the sitting position and look straight ahead;
• There are also long-term physical labor to reduce overwork, prevent the recurrence of joint pain and aggravate the condition, etc.

These measures are conducive to the recovery and alleviation of the disease.

(source:internet, reference only)

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