What are the American College of Rheumatology treatment guidelines for 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 stable AS:

  • Conditionally recommend on-demand treatment with NSAIDs over continuous treatment with NSAIDs
  • In patients receiving treatment with TNFi and NSAIDs, conditionally recommend continuing treatment with TNFi alone versus continuing both treatments
  • In patients receiving treatment with TNFi and a conventional synthetic antirheumatic drug, conditionally recommend continuing treatment with TNFi alone over continuing both treatments
  • In patients receiving treatment with a biologic, conditionally recommend against discontinuing it
  • In patients receiving treatment with a biologic, conditionally recommend against tapering of the biologic dose as a standard approach
  • In patients receiving treatment with an originator TNFi, strongly recommend continuing treatment with the originator TNFi over mandated switching to its biosimilar
  • Strongly recommend treatment with physical therapy over no treatment with physical therapy

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