If a person does not respond well to a TNFi, their doctor may consider Cosentyx (secukinumab). Cosentyx was approved by the US Food and Drug Administration (FDA) to treat active ankylosing spondylitis.
It works by blocking IL-17A, which is a proinflammatory cytokine (a molecular messenger that induces an inflammatory response in the body). IL-17A is known to play a major role in the development of AS.
Cosentyx is given subcutaneously once a week for four weeks, and then every four weeks thereafter. Research suggests that it’s well-tolerated, with the most common adverse effect being cold symptoms, like a runny nose and sore throat.
Research is still evolving on Cosentyx. Nonetheless, it’s exciting there is now an option for people whose disease continues to worsen on a TNF inhibitor or who cannot take a TNF inhibitor.
In rare instances, surgery is needed to treat ankylosing spondylitis. This is usually reserved for people with severe hip joint damage and pain. In these instances, a total hip replacement is often recommended over no surgery at all.
Riskier surgeries like those involving the spine are much less common and performed when there is severe downward curving of the spine (“hunchback posture”).
Some people choose to pursue alternative methods in addressing their AS as well. These methods have not been through the rigorous studies necessary for drug approval. However, some people with AS have reported benefits from the following:
- chiropractic treatment
- massage therapy
- transcutaneous electric nerve stimulation (TENS)
It is important to note that the effectiveness of these therapies has not been established. Chiropractic treatment, in particular, is a concern of mainstream physicians, who worry that it might lead to complications such as spinal fractures.
A Word From Verywell
Ankylosing spondylitis is a chronic disease, and there is no cure yet. However, there are ways to manage it. With the right treatment regimen (which will need tweaking over time under your doctor’s guidance), you can live well with AS.