Do you have Ankylosing Spondylitis? Let's talk about TNF Inhibitors

Do you also start your day with a stiff back and pain when you wake up in the morning? Are you tired of the pain that comes from your joints when you walk or move around? These could be symptoms of ankylosing spondylitis , or AS for short. This is a long-term inflammatory condition that occurs in the spine and other joints. So if you have this condition, your doctor may have talked about a special type of medication called TNF Inhibitors. Let's talk about this simply and clearly today.

Why do joints hurt in AS? What is TNF?

Okay, let's put this simply. We all have an immune system in our bodies. It's what protects us by fighting off germs that cause disease. But in conditions like AS, this immune system becomes overactive. It's like a guard who's always on alert.

When this happens, our bodies start to produce more of a special protein called Tumor Necrosis Factor, or TNF . This TNF protein is what causes inflammation in our joints, which means inflammation, swelling, redness, and pain. This is why joints like your back and hips become stiff, swollen, and painful.

So what are these TNF Inhibitors?

Simply put, TNF inhibitors are a type of medication that 'blocks' the TNF protein we talked about earlier, which is responsible for causing inflammation. These are not like regular painkillers. Painkillers only temporarily suppress pain. But TNF Inhibitors work much deeper than that.

Doctors also call these medications 'TNF blockers', 'biologics', or 'anti-TNF drugs'. There are several types of TNF inhibitors approved for AS:

• Adalimumab
• Certolizumab pegol
• Etanercept
• Golimumab
• Infliximab

Your doctor will usually consider this treatment when your symptoms are not controlled by painkillers (NSAIDs). Not all TNF inhibitors work for everyone. One drug may work well for some people, but not for others. So your doctor may try different medications until they find the one that works best for you.

How are these medicines used?

There are two main ways to give this medication , which will vary depending on the type of medication you are prescribed.

1. As an injection under the skin (Injection)

Some medications come as injections. The best part is that you can give them at home. Your doctor or a trained nurse will show you how to give them correctly. They are usually given in the skin of your stomach or thigh. The important thing is to rotate the injection site, not the same one every time.

2. Like a saline solution given into a vein (Intravenous Infusion)

Medicines like Golimumab and Infliximab are given as a saline solution into a vein. This requires you to go to a hospital or an infusion center. This treatment can take several hours. The doctor will usually give you the medicine for about two hours and then keep you under observation for another two hours to see if you have a serious allergic reaction. You may need to take this treatment every two weeks at first, but this time may be reduced over time.

What are the benefits of TNF Inhibitors?

Studies have shown that people with AS receive significant benefits from this treatment.

• The pain is significantly reduced.
• Joint function and flexibility improve.
• Symptoms such as morning joint stiffness and swelling are more likely to decrease.
• Reduces inflammation around the spine and other joints.
• Slows down permanent damage to joints over time.

Many people start to notice a difference after just two or three doses of the medication. However, it can sometimes take up to three months to see the full effects of this medication. Therefore, it is important to be patient with the treatment.

We are also aware of side effects.

Like any medication, this one can have side effects. However, most people only experience minor side effects. The most important thing is to be aware of this and inform your doctor immediately if you have any problems.

Because these medications suppress the activity of our immune system, our ability to fight germs may be slightly reduced. This slightly increases the risk of infections .

There is a risk of tuberculosis (TB) coming back. Don't worry, your doctor will test you for TB and other infections before you start this medication.

Below are some common side effects that may occur.

In some cases, this medication may slightly increase the risk of developing skin cancer (non-melanoma skin cancer), so your doctor will be aware of that as well.

Who should not use this medicine?

TNF Inhibitors are not suitable for everyone. Your doctor may not prescribe them if you have any of the following conditions:

• If you are a nursing mother .
• If you currently have an active infection .
• If you have a history of diseases such as lupus or multiple sclerosis .
• If you have cancer or precancerous cells (this may vary depending on the doctor's decision in cases of cancer that are more than 10 years old and that have been treated and cured).
• If you have a history of severe heart disease .

Can these be used during pregnancy?

This is an important question for many people. Studies have shown that most of these medications are safe to use during pregnancy. However, some medications, especially in the second or third trimester of pregnancy, can cross the placenta to the baby.

So if you are expecting a baby, definitely talk to your rheumatologist about this. He or she may be able to recommend a medication that is best for you, such as Certolizumab, which does not cross the placenta.

Ankylosing Spondylitis, TNF inhibitors, arthritis, back pain, biologics, anti-TNF