A review on ankylosing spondylitis

Abstract

Ankylosing spondylitis (AS) is a long-term inflammation of the joints of the spine which is complex, potentially debilitating disease that is insidious in onset, progressing to radiological sacroiliitis over a period of years. The pathogenesis of AS is poorly understood. However, immunomediated mechanisms involving human leukocyte antigen-B27, inflammatory cellular infiltrates, cytokines like tumor necrosis factor α and interleukin-10, and genetic and environmental factors are thought to have key roles. The presence of inflammatory back pain plus at least two other typical features of spondyloarthropathy such as enthesitis and uveitis is highly predictive of early AS. Nonsteroidal anti-inflammatory drugs (NSAIDs) effectively relieve inflammatory symptoms and are presently first line drug treatment. However, NSAIDs have an influence only on the symptomatic effect and has no effect on the disease. For symptoms unresponsive to NSAIDs, the second-line treatment includes corticosteroids and various disease modifying antirheumatic drugs are used.