Commonly used Western medicine treatments for ankylosing spondylitis (AS) (I)

1. Non-steroidal anti-inflammatory drugs: This type of drug can quickly improve symptoms and increase the range of motion of joints. It is the first choice for both early and late stages and is a first-line treatment. Patients with active AS should use it continuously, and patients with stable AS can use it as needed. This type of anti-inflammatory drug has varying degrees of gastrointestinal reactions, liver and kidney damage, hematopoiesis, edema, hypertension and other side effects. When using it, you can choose an anti-inflammatory drug for the specific patient. Any combined use of two or more anti-inflammatory drugs will not only fail to increase the efficacy, but may cause serious side effects.

2. Traditional disease-modifying drugs

1 Sulfasalazine: It can improve the pain, swelling and stiffness of AS, and is particularly suitable for improving the peripheral arthritis of AS, and can reduce and prevent the concurrent anterior uveitis, but there is a lack of evidence for its therapeutic effect on axial joint lesions and improving prognosis. This drug takes effect slowly, usually taking 4-6 weeks to take effect. Generally, it can be taken from a small dose of 0.5g, twice a day, and increase weekly until the total daily dose reaches 1.5-3g, taken in 2 doses.

2. Methotrexate: For patients with active AS, when anti-inflammatory drugs and sulfasalazine are ineffective, methotrexate can be used. It only improves peripheral joint changes, back pain, stiffness, iritis, and erythrocyte sedimentation rate and CRP levels of AS. There is no evidence of improvement in X-ray lesions of the axial skeleton.

3. Thalidomide: It has the effect of anti-TNF, anti-interleukin-1IL-1, IL.-6, prostaglandins and other inflammatory mediators, and also has the pharmacological effects of suppressing immunity, anti-inflammation and anti-angiogenesis. It has a good therapeutic effect on the central axis involvement of AS. It can improve clinical symptoms and delay the progression of the disease.

3. Biological agents: Biological agents for the treatment of AS: tumor necrosis factor TNF-a inhibitors, IL-17 inhibitors and IL-12/IL-23 inhibitors.