Introduction

Abstract

Only slightly more common in men than in women, ankylosing spondylitis (AS) is a chronic inflammatory disease which, probably as a result of an autoimmune response, causes inflammation in the sacroiliac joints, vertebrae and adjacent joints. Patients also frequently have inflammation of an enthesis (insertion of a tendon or ligament into the bone), the peripheral joints and the eye; the lungs, heart valves and kidneys are only rarely affected. The onset of symptoms – notably back pain and stiffness – is normally already noticeable in adolescence or early adulthood. Eventually, AS can cause the vertebrae to fuse together, with obvious adverse impact on patient mobility and function. To date, the disease has no cure, but drug and physical therapy can improve pain, inflammation and other symptoms considerably; indeed, even remission is now a realistic goal. A major breakthrough in the treatment of this disease was the demonstration of the high efficacy of the tumour necrosis factor (TNF)–blocking agents [1].