From the Guidelines
When evaluating a patient for Ankylosing Spondylitis (AS), it is crucial to ask about chronic low back pain lasting more than 3 months that improves with activity and worsens with rest, especially pain that awakens patients at night, as this is a hallmark feature of the disease 1. The key questions to ask include:
- Morning stiffness lasting more than 30 minutes
- Age of symptom onset (typically before age 45)
- Response to NSAIDs (often dramatic improvement)
- Family history of ankylosing spondylitis or other spondyloarthropathies
- Associated symptoms like uveitis, psoriasis, inflammatory bowel disease, or peripheral arthritis
- Systemic symptoms such as fatigue, weight loss, or fever
- Functional limitations in daily activities and posture changes These questions are essential because ankylosing spondylitis has an insidious onset with inflammatory back pain as its hallmark feature, and early diagnosis is critical to prevent disease progression and improve quality of life 1. The disease typically affects the sacroiliac joints and spine, causing progressive fusion if untreated, and physical examination findings like limited spinal mobility and sacroiliac joint tenderness, along with elevated inflammatory markers and HLA-B27 testing, will complement the history to establish the diagnosis 1. It is also important to consider the patient's individual characteristics, including comorbidities and psychosocial factors, when evaluating and managing AS, as treatment should be individualized according to the current signs and symptoms of the disease and the patient's characteristics 1.
From the FDA Drug Label
The FDA drug label does not answer the question.