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Updated: Dec 20, 2025

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Can structural damage be prevented in ankylosing spondylitis?

Joachim Sieper1

  • 1Medical Department I, Rheumatology, Charité, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany. Joachim.sieper@charite.de

Current Opinion in Rheumatology
|May 9, 2009
PubMed
Summary

Non-steroidal anti-inflammatory drugs may slow bone growth in ankylosing spondylitis, but tumor necrosis factor (TNF)-blockers do not. Further research is needed to determine the best approach for preventing structural damage.

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Area of Science:

  • Rheumatology
  • Immunology
  • Orthopedics

Background:

  • Ankylosing spondylitis treatments like NSAIDs and TNF-blockers manage symptoms.
  • Preventing structural damage, primarily new bone formation, remains a challenge.

Purpose of the Study:

  • To review current research on preventing structural damage in ankylosing spondylitis.
  • To explore the relationship between inflammation and new bone formation.

Main Methods:

  • Review of recent studies on ankylosing spondylitis treatments.
  • Analysis of molecular interactions between inflammation and bone formation.

Main Results:

  • NSAIDs may retard syndesmophyte growth over two years; TNF-blockers do not.

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  • TNF-blockade might induce new bone formation, suggesting it's effective only when inflammation is coupled and treated early.
  • Bone biomarkers suggest inflammation suppression can lead to new bone formation.

    • Conclusions:

    • Clarify if early inflammation treatment or targeting new bone formation is superior for preventing structural damage.
    • Further research is required to optimize ankylosing spondylitis management strategies.