© 2003 by BMJ Publishing Group & European League Against Rheumatism
LEADER
Ankylosing spondylitis
Established criteria for disease controlling drugs in ankylosing spondylitis
Centre for Prognosis Studies, Toronto Western Hospital, ECW 5-034B, Toronto, ON, Canada
Correspondence to:
Correspondence to:
Dr D D Gladman;
dafna.gladman@utoronto.ca
The ASAS recommendations for the initiation of DC-ART in AS are a good start
Keywords: ankylosing spondylitis; disease controlling antirheumatic drugs; tumour necrosis factor 
; biological agents
| The first 150 words of the full text of this article appear below. |
Ankylosing spondylitis (AS) is primarily an inflammatory arthritis of the back, affecting the sacroiliac and apophysial joints.1 The age of onset is usually late teens with men being affected nine times more than women. Onset is gradual with pain and stiffness in the low back, characteristically at night or early morning.2 The natural history of AS is progression to affect the whole spine, resulting in spinal deformities. These include flattening of the lumbar lordosis, kyphosis of the thoracic spine, and hyperextension of the cervical spine, with eventual flexion contractures of the hips and knees and significant morbidity and disability. These clinical features are mirrored by the radiological changes of syndesmophytes and ankylosis of the spine as well as erosive changes, sclerosis, and eventual ankylosis of the sacroiliac joints.3
Peripheral arthritis occurs uncommonly in AS, and when it occurs, it is usually late in the course of the arthritis.4
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