What are the latest treatments for ankylosing spondylitis?

Question

Hi doctor,

I had an update about my AS, and it is not good. The fusion in my lower back is getting worse, and I cannot even tie my shoes now. I am 37 years old, but sitting at a desk has become torture now. The biologics cause weird infections plus cost a fortune. Physiotherapy exercises feel impossible for me most days. The uveitis has flared up again for a third time this year. My wife keeps saying we should try for kids, but how can I be a dad when I can barely move? I am also worried about passing this on genetically. Are there any new treatments on the horizon? I am feeling pretty hopeless for a guy my age.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

It is completely understandable why you are feeling this way.

Ankylosing spondylitis (AS), especially with fusion in the spine and recurrent uveitis, can feel overwhelming. Several new treatments and approaches for AS are indeed emerging. One of the most promising is a class of medications targeting IL-17 (interleukin-17) and IL-23 (interleukin-23), specifically designed to reduce the inflammatory effects linked to AS. IL-17 inhibitors (such as Secukinumab) have shown efficacy even in cases where traditional biologics have not worked or caused problematic side effects, as you have experienced. There is also active research into JAK inhibitors (Janus kinase inhibitors). Oral medications like Tofacitinib may offer similar benefits without the injection or infusion route, which could ease some of the logistical and financial burdens. Speaking with your rheumatologist about newer options could be worthwhile, especially if your current biologic is not well tolerated.

Physical therapy does feel impossible on high-pain days, but sometimes even gentle movements, like seated stretches, water therapy, or breathing exercises, can help preserve flexibility and manage pain more sustainably. Pain specialists, too, might offer integrative approaches, such as nerve block injections, to reduce flare-ups and help manage daily functioning. Regarding starting a family, the genetic transmission of AS can happen, but it is not guaranteed, as AS has complex genetic and environmental factors. Parenting with AS might mean adjusting roles or finding ways to manage limitations, but many people with AS do lead fulfilling lives with children. Sharing your concerns openly with your wife, including your fears about passing on AS and your worries about physical limitations, could help you both make this decision together. You are facing a lot, but with new treatments, supportive care, and a comprehensive pain management plan, there is potential to regain some control over your life. You are not alone in this, and it is worth exploring all options to help you find relief and renewed hope.

I hope this information helps you.

Revert in case of queries.

Regards.