Subject: To participate in a survey on diagnosis and treatment of Ankylosing Spondylitis in India
Ankylosing spondylitis (AS) is a chronic, inflammatory disease primarily affecting the axial spine that can manifest with a range of clinical signs and symptoms. The hallmark features of the condition include chronic back pain and progressive spinal stiffness AS is characterized by the involvement of the spine and sacroiliac (SI) joints and peripheral joints, digits, and entheses.
AS often leads to impaired spinal mobility and can result in postural abnormalities. Patients can also experience buttock pain and hip pain. Peripheral arthritis, enthesitis, and dactylitis ("sausage digits") are all associated with AS. In addition to skeletal involvement, AS can affect various organs outside the joints. These extraarticular manifestations of AS include inflammatory bowel disease (affecting up to 50% of individuals), acute anterior uveitis (seen in 25%-35% of cases), and psoriasis (approximately 10% occurrence). AS is additionally linked to an increased risk of cardiovascular disease which is believed to stem from the systemic inflammation present in individuals with AS. Pulmonary complications are also associated with AS, as diminished chest wall expansion and limited spinal mobility can predispose individuals to a restrictive pulmonary pattern.
Finally, individuals with AS are at least twice as likely to experience vertebral fragility fractures. Additionally, they face an increased risk of atlantoaxial subluxation, spinal cord injury, and, rarely, cauda equina syndrome. The treatment goals for AS aim to alleviate pain and stiffness, preserve axial spine mobility and functional ability, and prevent spinal complications. Non-pharmacological interventions should include regular exercise, postural training, and physical therapy.
First-line medication therapy involves using non-steroidal anti-inflammatory drugs (NSAIDs) on a daily, long-term basis. If NSAIDs do not provide adequate relief, they can be combined with or substituted for tumor necrosis factor inhibitors (TNF-Is) such as adalimumab, infliximab, or etanercept. The response to NSAIDs should be assessed 4 to 6 weeks after initiation, while the response to TNF-Is should be evaluated after 12 weeks.
Systemic glucocorticoids are not recommended for treating AS, but local steroid injections may be considered for specific cases. Specialist referrals may be warranted based on the patient's clinical presentation, potential complications, and extra-articular manifestations of the disease. Rheumatologists may assist in the formal diagnosis, management, and monitoring of AS, while dermatologists, ophthalmologists, and gastroenterologists may assist with associated non- musculoskeletal features of the disease
This survey will help:
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To understand the demography of patients suffering from AS in India
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To understand the disease profile, its diagnosis, and the use of various medications in the management of AS
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To understand the drug usage pattern of various medications in the management of AS in India
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To understand the different approaches in the management of AS in India
If you agree to participate, you must provide an assessment response, to the standard questionnaire form. A link will be provided for the same on your registered email address.
We trust you and we are partners in safe and effective drug therapy. In that spirit, we hope you will consent to participate in this survey.
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