Ankylosing spondylitis
What is ankylosing spondylitis?
Ankylosing spondylitis (AS) is a chronic autoimmune disease and a form of arthritis that mainly affects the spine. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort.1
Ankylosing spondylitis can also cause inflammation, pain and stiffness in other areas of the body such as the shoulders, hips, ribs, heels and small joints of the hands and feet.1
As the condition worsens, many people assume a stooped position, which can lead to bad posture. Some people with the disease become disabled, and for those with a progressive form of the disease, severe deformities may develop. In severe cases, sufferers may become immobile.2
Who does it affect?
Ankylosing spondylitis is two to three times more common in men than women and primarily strikes young men from their teens to twenties.3 While the cause of ankylosing spondylitis is not known, genetics may play a role. Ninety per cent of people with ankylosing spondylitis share a common genetic marker (HLA B27), however possessing this gene does not always mean a person will develop the disease.4
It is estimated that between one and two per cent of Australians, and between 5-6,000 New Zealanders, suffer from ankylosing spondylitis.5,6
What are the symptoms?
Initial symptoms of ankylosing spondylitis include onset of pain and stiffness in the lower back and buttocks. The pain is often worse at night when sleeping or early morning.4
Patients with advanced ankylosing spondylitis may also experience:
- a loss of appetite
- weight loss, fatigue
- anaemia
- difficulty breathing due to inflammation in the rib cage.2
A large number of ankylosing spondylitis patients (up to 30 per cent) suffer from other conditions such as uveitis (inflammation of the eye), inflammatory bowel diseases and osteoporosis.4
Some patients may also experience depression, with loss of libido and diminished capacity to work, contributing to a lack of well-being.4
How is it diagnosed and managed?
Rheumatologists are specially trained to diagnose and treat ankylosing spondylitis. Diagnosis is based on medical history, symptoms, X-rays and blood tests. Unfortunately, diagnosis can often be challenging because symptoms are frequently attributed to common back problems.2
While there is no cure for ankylosing spondylitis, treatment is available to relieve pain and stiffness, and prevent or delay complications and spinal deformity. Pharmaceutical treatment options for ankylosing spondylitis include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), corticosteroids and tumour necrosis factor (TNF) inhibitors.2
Where can I get more information?
Talk to your doctor or healthcare professional or visit some of the following sites that may offer more information.
1 Spondylitis Association of America. About Ankylosing Spondylitis. http://www.spondylitis.org/about/as.aspx. Accessed Oct 20, 2009.
2 MayoClinic, Ankylosing Spondylitis http://www.mayoclinic.com/health/ankylosing-spondylitis/DS00483/METHOD=print. Accessed Oct 20, 2009.
3 American College of Rheumatology. Spondyloarthropathies. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/spondyloarthritis.asp?aud=pat. Accessed Oct 20, 2009.
4 Arthritis Foundation. Ankylosing Spondylitis, Disease Center. http://www.arthritis.org/disease-center.php?disease_id=2&df=causes. Accessed Oct 20, 2009.
5 Arthritis Australia. Ankylosing Spondylitis Patient Booklet. Accessed Oct 20, 2009.
6 Abbott HEOR data on file (supplied in Pharmac submission).