What are the American College of Rheumatology treatment guidelines for patients with active or stable ankylosing spondylitis (AS)?

Updated: Feb 02, 2021
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In adults with active or stable AS:

  • Conditionally recommend against co-treatment with a TNFi and low-dose methotrexate
  • Conditionally recommend advising unsupervised back exercises
  • Conditionally recommend evaluation and counseling regarding falls
  • Conditionally recommend participation in formal group or individual self-management education
  • In patients with spinal fusion or advanced spinal osteoporosis,strongly recommend against treatment with spinal manipulation
  • In patients with advanced hip arthritis, strongly recommend treatment with total hip arthroplasty over no surgery
  • In patients with severe kyphosis, conditionally recommend against elective spinal osteotomy

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