Many patients with ankylosing spondylitis (AS) could be treated with biologics – in particular, biologic disease-modifying antirheumatic drugs (DMARDs). However, this line of treatment is not efficacious nor well-tolerated for all individuals. So what therapeutic options are available for those who do not respond well to biologics?
According to an article in Healio, a research study found that upadacitinib (which may also be described under the brand named RINVOQ) could be beneficial for this group of patients. To evaluate the therapy, researchers enrolled 420 individuals with active ankylosing spondylitis into the study. Those enrolled had also poorly responded to at least two, if not more, DMARDs or other therapies.
During the SELECT-AXIS 2 trial, patients received 15mg upadacitinib (or a placebo) daily for a 14-week period. Patients visited researchers during 6 of the trial weeks, and underwent sacroiliac joint and spine MRIs at the onset of the trial and at week 14.
The data, which you can find in the Annals of the Rheumatic Diseases, highlighted the benefits of upadacitinib for ankylosing spondylitis. 45% saw reduced symptoms and other benefits compared to just 18% of those taking the placebo. While some adverse reactions did occur, upadacitinib was relatively safe and well-tolerated overall.
What is Ankylosing Spondylitis (AS)?
Ankylosing spondylitis (AS) exists under the umbrella of spondyloarthropathies. The condition is aptly named: “ankylosing,” referring to vertebral fusion in the back, and “spondylitis,” referring to joint inflammation between the pelvic bones and at the base of the spine. Therefore, you might say that ankylosing spondylitis is an arthritic condition which causes chronic spinal inflammation which may spread to the shoulders, hips, and knees. Various genes, such as HLA-B27, IL1A, IL23R, and ERAP1 have been associated with ankylosing spondylitis, though researchers are still working to research these associations. Additionally, many researchers believe that genetic and environmental factors both play a role in this condition.
This condition is most common in males and often manifests in early adulthood. Symptoms and characteristics can (but do not always) include:
- Lower back pain and stiffness
- Difficulty breathing or taking deep breaths
- Hip, joint, and neck pain
- Uveitis (eye inflammation)
- Note: If you have AS and are experiencing light sensitivity or eye pain, please visit your doctor. Without treatment, uveitis can cause vision loss.
- Fatigue
- Appetite loss
- Unintended weight loss
- Abdominal pain and diarrhea
