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Is TNF inhibitor therapy helpful for ankylosing spondylitis?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have had ankylosing spondylitis (HLA B27 positive) for the past 12 years, and with pulmonary tuberculosis the very next year. And took medicine for nine months, and now I am daily taking Saaz, and I am going to plan for Biologics.

The doctor suggested Etanercept 50 mg, but I am afraid of side effects, as I have already been affected by TB for 11 years. Shall I go for biologic Etanercept 50 mg, and what precautions should I take during biologics? I'm sharing the report here.

Kindly help.

Answered by Dr. Ashaq Hussain Parrey

Education:

MBBS

Professional Bio:

Dr. Ashaq Hussain Parrey is a doctor who completed his MBBS and MD in General Medicine from Sher - i - Kashmir Institute of Medical Sciences and has over 17 years of experience in clinical practice. He is currently working as Assistant professor medicine, Rheumatology Government Medical College Srinagar.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

You need to do the Mantoux test and interferon gamma level before starting biologics because they can cause reactivation of tuberculosis. If there is doubt, you should receive the two-drug ATT regimen (anti-tubercular treatment) before starting biologics, which is recommended if either Montoux or interferon gamma is positive.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

Mantoux test is positive, PPD is 5 TU.

Please help.

Answered by Dr. Ashaq Hussain Parrey

Education:

MBBS

Professional Bio:

Dr. Ashaq Hussain Parrey is a doctor who completed his MBBS and MD in General Medicine from Sher - i - Kashmir Institute of Medical Sciences and has over 17 years of experience in clinical practice. He is currently working as Assistant professor medicine, Rheumatology Government Medical College Srinagar.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome back to icliniq.com.

Then better would take three months regimen for tuberculosis before starting ATT. You may not have tuberculosis, but prevention is always better than cure.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

Medically reviewed by Dr. Nithila. A
Published At June 13, 2019
Reviewed At November 17, 2025

Education:

MBBS

Professional Bio:

Dr. Ashaq Hussain Parrey is a doctor who completed his MBBS and MD in General Medicine from Sher - i - Kashmir Institute of Medical Sciences and has over 17 years of experience in clinical practice. He is currently working as Assistant professor medicine, Rheumatology Government Medical College Srinagar.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Nithila A is a Dental Surgeon specializing in providing comprehensive oral healthcare. She focuses on preventive care, routine dental treatments, and patient education to maintain optimal oral health. Known for her compassionate and patient-centered approach, she ensures comfortable and effective dental care tailored to the individual needs of each patient.

This doctor is not available for online consultations on the platform anymore.

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Education:

MBBS

Professional Bio:

Dr. Ashaq Hussain Parrey is a doctor who completed his MBBS and MD in General Medicine from Sher - i - Kashmir Institute of Medical Sciences and has over 17 years of experience in clinical practice. He is currently working as Assistant professor medicine, Rheumatology Government Medical College Srinagar.

This doctor is not available for online consultations on the platform anymore.

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