The exact cause of this immune response is unknown, but a gene called HLA-B27 may play a role. HLA-B27 is part of a family of genes that helps the immune system tell the difference between foreign substances and your body’s own cells. Many people with ankylosing spondylitis have the HLA-B27 gene, but not everyone with the gene develops the condition. An environmental trigger, such as an illness or bacterial infection, may activate the immune response of ankylosing spondylitis.
How Biologics Target Ankylosing Spondylitis Inflammation
Biologics are a type of disease-modifying antirheumatic drug (DMARD), meaning that in addition to relieving symptoms of ankylosing spondylitis, they also help block the inflammatory process in your body before it even starts. Unlike traditional DMARDs, which suppress the immune system on a broad level, biologics work by targeting specific molecules that play a role in triggering inflammation. “Biologics target specific pathways known to cause inflammation in the cartilage, bones, and joints,” says Harris H. McIlwain, MD, a board-certified rheumatologist and founder of McIlwain Medical Group in Tampa, Florida. “When inflammation starts, there may be pain, stiffness, and fatigue. Biologics may halt the process of inflammation and end pain. In doing so, they may give excellent improvement in pain, inflammation, and function.” Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first medication prescribed to treat ankylosing spondylitis. These drugs, which include over-the-counter and prescription options, help ease symptoms such as pain and stiffness. If NSAIDs aren’t providing enough relief, you may be a candidate for a biologic. Your doctor may prescribe a traditional DMARD, such as sulfasalazine, if you also have arthritis in the joints of your arms and legs. These are not typically used if ankylosing spondylitis affects your back only. Your exact treatment plan will depend on a number of factors, including your disease severity, personal preferences, medical history, and overall health. You’ve learned a lot about biologics. So what’s next for you? Take some time to think about your own ankylosing spondylitis care and whether biologics are something you might want to consider. Then talk to your doctor about your options.
