That’s because biologics work by suppressing certain inflammation-causing molecules in the immune system, and a weakened immune system can increase your risk of contracting infections.
What Are Biologics?
Chronic inflammation of the spine can lead to stiffening of joints and fusion of bone to other bones (ankylosis) — a hallmark of ankylosing spondylitis. “Biologics help treat ankylosing spondylitis by targeting different proteins in the body called cytokines," says Natalie E. Azar, MD, an assistant clinical professor of medicine and rheumatology at NYU Langone Medical Center in New York City. “There is evidence that blocking these proteins can mitigate the inflammation that can promote ankylosis.” Most biologics for ankylosing spondylitis block a protein called tumor necrosis factor alpha (TNF-alpha). Others work by targeting interleukin-17, another protein linked to ankylosing spondylitis.
How to Stay Healthy
There isn’t a magic bullet to ensure good health when taking a biologic drug, Dr. Azar says. But in addition to following your ankylosing spondylitis treatment regimen as directed, there are steps you can take to help reduce your risk of infection and stay healthy year-round. The CDC provides the following guidelines for when to wash your hands:
After going to the bathroomBefore, during, and after food preparationBefore eatingBefore and after taking care of someone who is illBefore and after treating a woundAfter changing a diaper or cleaning someone who has used the toiletAfter coughing, sneezing, or blowing your noseAfter touching animals, animal waste, or pet foodAfter touching garbage
2. Get vaccinated
Your doctor will review your medical history and current state of ankylosing spondylitis to determine which vaccinations would be beneficial for you. Typically, an annual influenza (flu) vaccine is recommended, as is the shingles vaccine (given one time) and the pneumonia vaccine (administered every 5 to 10 years), Azar says. It’s recommended to get the COVID vaccine as well. Screening for tuberculosis (TB) exposure is also performed on an annual basis.
3. Eat a healthy diet
There’s no one diet that’s right for everyone with ankylosing spondylitis. In the last several years, however, many rheumatologists have begun advising people with the condition to try to adhere to an anti-inflammatory diet, Azar says. “This is comprised of foods rich in omega-3 fatty acids, whole fruits and vegetables, nuts, virgin olive oil, and fiber-rich complex carbohydrates, to name a few. Perhaps more importantly, an anti-inflammatory diet is also heart healthy, which is especially relevant for people with ankylosing spondylitis,” she adds. That’s because ankylosing spondylitis can increase your risk of heart disease and stroke.
4. Exercise regularly
Staying active is one of the best things you can do for ankylosing spondylitis, according to the Spondylitis Association of America (SAA): Exercise can help relieve pain, improve posture, increase flexibility, reduce stress, and improve your overall health. You should talk to your doctor before beginning any exercise regimen to help prevent your risk of injury. Consider including these different forms of exercise in your regimen:
Abdominal and back exercises can help reduce back stiffness and encourage good posture. Practicing good posture can help to minimize complications of ankylosing spondylitis.Strengthening exercises — with weights, or by repetitions of tightening muscles without moving the joints — help build muscles around painful joints to encourage better support.Range-of-motion exercises help reduce stiffness, improve movement, and increase flexibility. Ask your doctor about which range-of-motion exercises might be best for you.Stretching exercises can be helpful if your spine is painful or inflamed. Stretching and extending the back in careful, controlled motions can be beneficial for preventing long-term disability.Exercising in water can be good for people who have ankylosing spondylitis because it’s gentle on your joints. Try a water exercise class if you like to socialize while exercising.
5. Don’t smoke
It’s well-known that smoking is bad for your health and can compromise your immune system, making it more difficult for your body to fight off disease and infection, according to the CDC. But people with ankylosing spondylitis may experience additional consequences of smoking because the disease can affect the mobility of their rib cage. Breathing can be further compromised if the lungs are damaged from smoking. Let your doctor know if you need help to stop smoking.
6. Get regular health screenings
Up to 50 percent of people with ankylosing spondylitis will develop inflammation of the eye at least once. Known as uveitis, this complication can become serious if left untreated, according to the SAA. When it’s detected early, uveitis can usually be treated with prescription eye drops. Make an annual appointment during your birth month or near a favorite holiday so you remember to have your eyes checked each year. If at any point you experience symptoms of uveitis such as eye pain or redness, blurred vision, or sensitivity to light, see your eye doctor right away. Ankylosing spondylitis can also increase your risk of other conditions, such as osteoporosis, heart disease, and inflammatory bowel disease, so it’s important to see your doctor regularly for screenings and to discuss ways to reduce your risk. Getting regular preventive health exams, such as your annual well-visit and any recommended cancer screenings, can reduce your risk of getting sick and help you stay healthy overall.
7. Talk to your doctor about your treatment
Even if your ankylosing spondylitis is well-controlled, it’s still important to see your doctor regularly. Your doctor can suggest how frequently you should come in. “In general, people with ankylosing spondylitis should see their doctor every three months or so,” Azar says. Schedule these appointments for the start of each new season. If your ankylosing spondylitis is stable and responding well to treatment, the minimum for visits with your doctor should be twice a year to monitor your condition, she says. If you feel your treatment isn’t working as well as it could, or you’re having trouble taking your medication as prescribed, talk to your doctor about making adjustments to your treatment plan. Never stop taking your medication without talking to your doctor first. You should also let your doctor know about any other medications or supplements you’re taking to avoid any potential interactions with your ankylosing spondylitis medication. Taking these steps to stay healthy year-round can help you get the most from your biologic treatment for ankylosing spondylitis and improve your health overall. Additional reporting by Erica Patino
