Definition
Among the highly debilitating rheumatic diseases, ankylosing spondylitis plays an important role: we are talking about a systemic and autoimmune pathology, with a chronic course, involving the vertebral column and the musculoskeletal system. By degenerating, ankylosing spondylitis can lead to a real fusion of the joints.
Causes
The cause of ankylosing spondylitis lies in a genetic abnormality; it is considered possible that the presence of the HLA-B27 gene in Caucasian patients and the HLA-B7 gene in blacks can heavily affect the onset of the disease. Ankylosing spondylitis is an almost exclusively male disease.
Symptoms
An ankylosing spondylitis patient often complains of pain and stiffness in the back, especially in the morning and at times of inactivity. As the disease progresses, back pain gradually increases and the damage extends to several points in the spine, with changes in the spine and difficulty moving.
- Complications: cardiovascular changes, anemia, low-grade fever, pulmonary fibrosis, aortic insufficiency, Crohn's disease, acute uveitis
Information on ankylosing spondylitis - drugs for the treatment of ankylosing spondylitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Ankylosing Spondylitis - Ankylosing Spondylitis Treatment Medicines.
drugs
Unfortunately, the initial symptoms of ankylosing spondylitis, vague and blurred, can delay the diagnosis; the disease, discovered in the advanced stage, is not reversible, consequently there is no drug capable of reversing the disease.
In general, the goal of treatment is to reduce pain and, when possible, correct any damage and deformities affecting the spine and joints.
For pain control, the most widely used drugs in therapy are anti-inflammatories (NSAIDs) and some corticosteroids, to be taken orally or intravenously.
- Ibuprofen (eg. Noan, Vatran, Pedea) As an indication, to control the pain associated with ankylosing spondylitis, it is recommended to take 400-800 mg of active, every 6-8 hours, as needed. It is also possible to take the drug intravenously (400-800 mg / 30 minutes every 6 hours, as needed). Indicated to treat the painful symptoms that accompany the mild forms of ankylosing spondylitis.
- Diclofenac (eg. Fastum, Dicloreum): for the control of mild pain associated with ankylosing spondylitis (early stage), it is recommended to take 25 mg of active, 4 times a day. Follow the directions given by your doctor.
- Celecoxib (eg Onsenal): selective inhibitor of cyclooxygenase II. For the treatment of ankylosing spondylitis, it is recommended to take the drug orally, at a dose of 200 mg, in a single dose or in two divided doses. If, after a 6-week treatment, the patient experiences no benefit, it is possible to increase the dose up to 400 mg a day. Alternatively, change therapy.
- Prednisone (eg. Deltacortene, Lodotra): corticosteroid drug used in therapy to reduce inflammation, even in the context of ankylosing spondylitis. Prolonged steroid treatment can cause serious side effects, such as diabetes, osteoporosis and cataracts. Indicatively, the dosage foresees to take 5-60 mg of drug, fractionated in 1-4 doses per day.
- Paracetamol (eg Acetamol, Tachipirina): to lighten the pain associated with mild ankylosing spondylitis, paracetamol exerts a discrete therapeutic action. Please note that the drug is not an anti-inflammatory. Take the drug orally in the form of tablets, syrup, effervescent sachets or suppositories; it is recommended to take paracetamol at a dosage of 325-650 mg every 4-6 hours for 6-8 consecutive days, to reduce fever, which is often associated with ankylosing spondylitis. The drug can also be taken intravenously: 1 gram every 6 hours or 650 mg every 4 hours for adults and adolescents weighing more than 50 kilos: if the patient weighs less than 50 kilos, give 15mg / kg every 6 hours or 12, 5 mg / kg every 4 hours. Consult your doctor.
- Sulfasalazine (eg Salazopyrin): an anti-inflammatory-immunomodulatory drug indicated to treat the symptoms of ankylosing spondylitis involving peripheral joints. Indicatively, take 500 mg of the drug the first week of treatment; the dose should be increased gradually: the second week it is possible to take 500 mg of active twice a day, while in the third week of treatment it is recommended to take 500 mg orally in the morning, followed by 1000 mg in the evening. The maintenance dose instead involves taking 1000 mg of drug orally, twice a day. If the patient does not report benefit after 3 weeks of therapy, it is possible to increase the dose of the drug up to a maximum of 3 grams per day. Consult your doctor.
- Methotrexate (eg. Reumaflex, Methotrexate HSP, Securact): the drug is an antagonist of folic acid synthesis, able to heavily influence the body's immune response. It is indicated to lighten the symptoms that accompany ankylosing spondylitis, especially when peripheral joints are involved. In general, take 7.5 mg of the drug once a week. Alternatively, take three doses of 2.5 mg orally, every 12 hours, once a week. Do not exceed 20 mg a week.
- Adalimumab (eg Humira): biologic injectable drug. It is recommended to take 40 mg of the drug, subcutaneously, every other week. In combination with this drug, NSAIDs, corticosteroids or methotrexate may also be prescribed. Consult your doctor.
- Etanecerpt (eg Enbrel): the drug is an inhibitor of tissue necrosis factor, a chemical messenger present in diseases such as rheumatoid arthritis and ankylosing spondylitis. The active ingredient should be administered subcutaneously at a dose of 25 mg, twice a week; alternatively, you can take a dose of 50 mg once a week. Children with this disorder can take the drug based on their body weight. Consult your doctor.
- Infliximab (eg Remicade): this is also a biological drug widely used in therapy for the control of pain associated with ankylosing spondylitis. The indicative dosage is to take 5 mg / kg of drug on the second and sixth week of treatment (starting to count from the first infusion). Subsequently, continue with this administration every 6-8 weeks. If the ankylosing spondylitis patient does not report any treatment effect after the sixth week, it is recommended to stop treatment and change therapy, consult a doctor.
- Golimumab (eg Simponi): probably new-generation drugs like golimumab are far more effective than those of the first generation. It is an anti-inflammatory drug used in therapy both for the treatment of rheumatoid arthritis and for ankylosing spondylitis. The drug is administered monthly subcutaneously, at a dose of 50 mg. It is recommended to always inject the drug on the same day of the month. The patient who weighs over 100 kilos can take a double dose (100 mg).
In light of recent studies, it seems that a diet rich in omega 3 can decrease inflammation (or at least prevent its degeneration), as well as reduce pain and postural rigidity. It should be remembered, however, that omega 3 supplementation, in a healthy and balanced diet, cannot replace, but only enrich, the pharmacological treatment for ankylosing spondylitis.
