Understanding the Application of Biologics in Managing Ankylosing Spondylitis
Ankylosing spondylitis (AS), a chronic inflammatory disease, can cause severe pain and stiffness in the spine and other joints. Biologics, a type of medication made from living organisms, are proving to be an effective treatment option for AS.
Biologics, typically proteins designed to replicate the functions of naturally occurring ones in the immune system, may increase the risk of developing or having a recurrence of infections, including hepatitis B or C, tuberculosis, and fungal infections. However, they have an overall good safety record, and most people tolerate them well.
There are currently three main types of biologics used in AS management: TNF inhibitors, IL-17 inhibitors, and IL-12/23 inhibitors.
TNF inhibitors, such as infliximab and adalimumab, work by blocking tumor necrosis factor-alpha, a pro-inflammatory cytokine that plays a central role in the inflammatory process of AS. By reducing inflammation, joint damage, and symptoms, TNF inhibitors provide an effective treatment for AS.
IL-17 inhibitors, like secukinumab, selectively bind to and inhibit IL-17A, a pro-inflammatory cytokine mainly produced by Th17 cells, which contributes to chronic inflammation in AS. By blocking IL-17A interaction with its receptor, these inhibitors reduce inflammation and joint damage associated with AS.
Some biologics now have one or several similar biosimilar products available, which a doctor may offer instead of the biologic. Biosimilars are medications that have a very similar structure and function to biologics.
Dr. Robert Koval, a board-certified rheumatologist, recommends biologics when people do not respond well to initial treatment options or start developing new symptoms despite treatment. His goal when using biologics is for the person to achieve "complete resolution of symptoms."
It is crucial for individuals who are pregnant or nursing, those using live vaccines, individuals receiving certain treatments, people with active infections, and those living in areas with common fungal infections to consult a doctor before using biologics.
Common side effects of biologics may include an increased risk of infection, reactions at the injection site, and reactions to the infusion. However, a 2021 report analyzing 48 studies on the adverse effects of anti-IL-23 treatments did not identify any significant links between these medications and increased cancer risk.
In conclusion, biologics offer an effective and generally safe treatment for ankylosing spondylitis when a person does not respond to first-line therapies or their symptoms worsen. A person can talk with a doctor if they are concerned they have a higher risk of complications while taking biologics or if they experience adverse reactions.
References:
- Novel cell therapies such as mesenchymal stem cells and CAR-T cells are emerging but remain experimental.
- Secukinumab selectively binds to and inhibits IL-17A, a pro-inflammatory cytokine mainly produced by Th17 cells, which contributes to chronic inflammation in AS by activating downstream inflammatory pathways. By blocking IL-17A interaction with its receptor, secukinumab reduces inflammation and joint damage associated with AS.
- The immune system in AS mistakenly attacks healthy cells, causing inflammation, and the proteins interleukin (IL) and tumor necrosis factor (TNF) contribute to this inflammation.
- Biosimilars of these TNF inhibitors, like infliximab biosimilar CT-P13, are also available and show similar effectiveness and safety in AS treatment.
- In the realm of medical-conditions like ankylosingspondylitis, which is a type of chronic disease affecting the musculoskeletal system, science continues to explore novel treatments, including uncategorized therapies and treatments such as mesenchymal stem cells and CAR-T cells, which are still experimental.
- Biologics, a growing part of health-and-wellness strategies for managing chronic diseases, are effective in treating ankylosingspondylitis, a neurological-disorder that can lead to severe pain and stiffness in the spine and other joints.
- These treatments, which are typically proteins designed to replicate the functions of naturally occurring ones in the immune system, may increase the risk of developing or having a recurrence of infections, such as hepatitis B or C, tuberculosis, and fungal infections, but have an overall good safety record.
- Some biologics, like TNF inhibitors (such as infliximab and adalimumab) and IL-17 inhibitors (like secukinumab), are used in the management of ankylosingspondylitis, with TNF inhibitors working by blocking tumor necrosis factor-alpha, a pro-inflammatory cytokine, and IL-17 inhibitors selectively binding to and inhibiting IL-17A, another pro-inflammatory cytokine that contributes to chronic inflammation in AS.
- With the emergence of biosimilars, a person may be offered these cost-effective alternatives instead of the original biologics, as they have a very similar structure and function, allowing for effective treatment of chronic diseases such as ankylosingspondylitis while promoting an affordable health-and-wellness lifestyle.
