Which treatment is considered first-line for Ankylosing Spondylitis?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are regarded as the first-line treatment for Ankylosing Spondylitis (AS) due to their efficacy in managing pain and inflammation associated with this chronic inflammatory disease. AS primarily affects the axial skeleton, leading to significant discomfort, stiffness, and potential disability over time.

NSAIDs work by blocking the production of prostaglandins, which play a crucial role in the inflammatory response. Their use helps improve mobility and reduce symptoms, and many patients experience substantial relief. Clinical guidelines and studies often support the recommendation of NSAIDs as an initial approach in treating AS, emphasizing their safety profile and the long-standing evidence of effectiveness.

Other treatments may be introduced based on the severity of symptoms and the patient's response to the initial therapy. Corticosteroids can be useful in specific situations, particularly in severe flares or extra-articular manifestations but are not the first-line due to possible side effects associated with long-term use. Antimalarials are not effective for AS and are typically utilized for conditions like rheumatoid arthritis or lupus. Biologics are effective in managing AS, particularly when NSAIDs are insufficient, but they are usually considered after first-line treatment options.