Ankylosing spondylitis


What is Ankylosing Spondylitis

Ankylosing spondylitis, also known as axial spondyloarthritis, is an inflammatory disease that, over time, can cause some of the bones in the spine, called vertebrae, to fuse. This fusing makes the spine less flexible and can result in a hunched posture. If ribs are affected, it can be difficult to breathe deeply. Axial spondyloarthritis has two types. When the condition is found on X-ray, it is called ankylosing spondylitis, also known as axial spondyloarthritis. When the condition can't be seen on X-ray but is found based on symptoms, blood tests and other imaging tests, it is called nonradiographic axial spondyloarthritis.

How common is Ankylosing Spondylitis

Onset generally occurs in late adolescence or early adulthood. Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at a greatly increased risk of developing ankylosing spondylitis. Most people who have ankylosing spondylitis have the HLA-B27 gene. However, only some people with the gene develop the condition.

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What are the symptoms of Ankylosing Spondylitis

Early symptoms of ankylosing spondylitis might include back pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals. The areas of the body most commonly affected are:

  • The joint between the base of the spine and the pelvis.
  • The vertebrae in the lower back.
  • The places where tendons and ligaments attach to bones, mainly in the spine, but sometimes along the back of the heel.
  • The cartilage between the breastbone and the ribs.
  • The hip and shoulder joints.

In severe ankylosing spondylitis, new bone forms as part of the body's attempt to heal. This new bone gradually bridges the gap between vertebrae and eventually fuses sections of vertebrae. Those parts of the spine become stiff and inflexible. Fusion also can stiffen the rib cage, restricting lung capacity and function.

Other complications might include:

  • Eye inflammation, called uveitis. One of the most common complications of ankylosing spondylitis, uveitis can cause rapid-onset eye pain, sensitivity to light and blurred vision. See your health care provider right away if you develop these symptoms.
  • Compression fractures. Some people's bones weaken during the early stages of ankylosing spondylitis. Weakened vertebrae can crumple, increasing the severity of a stooped posture. Vertebral fractures can put pressure on and possibly injure the spinal cord and the nerves that pass through the spine.
  • Heart problems. Ankylosing spondylitis can cause problems with the aorta, the largest artery in the body. The inflamed aorta can enlarge to the point that it distorts the shape of the aortic valve in the heart, which impairs its function. The inflammation associated with ankylosing spondylitis increases the risk of heart disease in general.]

How is it diagnosed

Doctors may diagnose ankylosing spondylitis with a physical exam, medical and family history, and imaging and lab tests. A physical exam may include examining your joints, including your spine, pelvis, heels, and chest. They may also watch you move and bend in different directions, checking for flexibility. Doctors also use X-rays and Magnetic resonance imaging (MRI) to see joint changes. However, you may have the disease for years before the changes show on x-rays. Doctors may use x-rays to monitor the progression of the disease or to rule out other causes for the joint pain. An MRI uses energy from a powerful magnet to produce signals that create a series of cross-sectional images. These images or “slices” are analyzed by a computer to produce an image of the joint. MRI can help diagnose ankylosing spondylitis in the early stages of the disease. Doctors may also do bloodwork to detect the HLA-B27 gene, which is common in people who develop ankylosing spondylitis.


Ankylosing Spondylitis

The following specialty medications are available at Accredo, a specialty pharmacy for Ankylosing spondylitis.

Medication Manufacturer
Amjevita™ (adalimumab-atto) Amgen, Inc.
Avsola™ (infliximab-axxq) Amgen, Inc.
Cimzia® (certolizumab) UCB, Inc.
Cosentyx™ (secukinumab) Novartis Pharmaceuticals Corp.
Cyltezo® (adalimumab-adbm) Boehringer Ingelheim Pharmaceuticals, Inc.
Enbrel® (etanercept) Amgen, Inc.
Humira® (adalimumab) AbbVie, Inc.
Inflectra® (infliximab-dyyb) Pfizer, Inc.
Remicade® (infliximab) Janssen Biotech, Inc.
Renflexis® (infliximab-abda) Organon
Rinvoq™ (upadacitinib) AbbVie, Inc.
Simponi Aria® (golimumab) Janssen Biotech, Inc.
Simponi® (golimumab, self inject) Janssen Biotech, Inc.
Taltz® (Ixekizumab) Eli Lilly & Co.
Xeljanz® (tofacitinib) Pfizer, Inc.

Financial Guidance

Life-saving specialty medication can be expensive. Learn how the Accredo teams help individuals find ways to afford the medication they need to survive in this video.

Find Support

There are many organizations that support research and advocacy for Ankylosing spondylitis. See below for a few of those organizations.

Support Organizations

Government Organizations

Meet the Team

Accredo’s Ankylosing spondylitis team is dedicated to serving you, and we understand the complexity of your condition. Our specialty-trained clinicians are available 24 hours a day, seven days a week, to answer any questions.

Why We Do It

Accredo supports patients with chronic and complex conditions and helps them live their best life. Watch our video to learn why we do what we do for our patients.

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