Ankylosing Spondylitis
What Is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a type of chronic inﬂammatory arthritis
that primarily aﬀects the spine.1
The inﬂammation in the joints and tissues of the spine can cause
pain and structural changes of the bone.2
These changes can result in stiﬀness, stooped posture, andlimited movement.2

Prevalence & Risk Factors
The worldwide prevalence of AS varies regionally, ranging from an estimated
7 to 32 people per 10,000.3 In the U.S., about 0.5% of the population isliving with AS.4
AS typically develops in patients in their mid-20s.5
The cause of AS is unknown, with a person’s risk of developing the disease
thought to be linked to multiple genetic and environmental factors.1,2
9 out of 10 people with AS carry a particular gene known as human leukocyte
antigen B27 (HLA-B27). Having this gene does not necessarily mean that aperson will develop AS. It's estimated that 8 in every 100 people in thegeneral population have the HLA-B27 gene, but most do not have AS.
AS can run in families, and the HLA-B27 gene can be inherited from a parent.6,7Symptoms & Complications
AS primarily aﬀects the spine
but may also impact otherareas of the body.1

Complications due to AS may include:
Eye inﬂammation
Heart problems

Spinal symptoms
may include:(rare cases)

Diﬃculty breathing• Back pain (mild to severe)(rare cases, fromstiﬀened rib cage)• Back stiﬀness

Neurologicalcomplications(incontinence and absenceof normal reﬂexes inthe ankle)• Fusing of vertebrae overtime, limiting movement

Spine fracture

In some people, AS may also
aﬀect the rib cage, shoulders,
hips, knees, and small joints of
the hands and feet.

Inﬂammation of thelarge intestine
Tightness in theback of the heel

Disease Burden
AS has a far-reaching impact on the body. Patients can experiencechronic pain and fusing of the bones in the spine that can limit
ﬂexibility and movement.8 Patients with AS are also at an increased
risk of heart problems.9
AS can place a signiﬁcant burden on other aspects of daily life, including:Sleep

Ability to work

Worsening symptoms in theearly morning hours can cause
sleep disturbances8

10%-20% of patients experience
work disability with lost income
and productivity10

Diagnosis & Treatment
Sacroiliitis, or the inﬂammation of the joints where the lower spine and pelvis
connect, is the typical feature of AS used in diagnosis.
Detection of inﬂammation early in the disease course before structuralchanges occur is crucial. However, because awareness of this disease is low,patients often confuse their symptoms with those of generic back pain,
which can lead to delays in diagnosis and potentially signiﬁcant,irreversible damage.5,11
Treatment of AS is aimed at relieving pain and stiﬀness and preventing ordelaying progression.2,5
MEDICINAL TREATMENTS• Nonsteroidal antiinﬂammatory drugs• Corticosteroids• Biologics

EXERCISE• Physical therapy• Range-of-motion exercises• Stretching

Though rare, surgery may be needed in severe cases.1
While therapies are available, there remains a signiﬁcant unmet need for more
eﬀective treatment options that target the underlying inﬂammation and help
modify the course of the disease.

Bristol Myers Squibb is committed to researching and pursuing newpotential treatment options to help patients and their loved ones with theburden of AS and other immune-mediated diseases.

1. National Center for Advancing Translational Sciences. Ankylosing spondylitis. Accessed March 15, 2021. https://rarediseases.info.nih.gov/diseases/9518/ankylosing-spondylitis
2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis. Published online February 2020. Accessed March 15, 2021.
https://www.niams.nih.gov/health-topics/ankylosing-spondylitis/advanced
3. Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology. 2014;53(4):650-657. doi:10.1093/rheumatology/ket387
4. Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci. 2013;345(6):431-436.
5. Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379-1390. doi:10.1016/S0140-6736(07)60635-7
6. Brown MA, Kenna T, Wordsworth BP. Genetics of ankylosing spondylitis–insights into pathogenesis. Nat Rev Rheumatol. 2016;12(2):81-91. doi:10.1038/nrrheum.2015.133
7. Akkoc N, Khan MA. Looking into the new ASAS classification criteria for axial spondyloarthritis through the other side of the glass. Curr Rheumatol Rep. 2015;17(6):42. doi:10.1007/s11926-015-0515-2
8. Johns Hopkins Arthritis Center. Ankylosing spondylitis. Accessed March 15, 2021. https://www.hopkinsarthritis.org/arthritis-info/ankylosing-spondylitis/
9. Eriksson JK, Jacobsson L, Bengtsson K, Askling J. Is ankylosing spondylitis a risk factor for cardiovascular disease, and how do these risks compare with those in rheumatoid arthritis? Ann Rheum Dis.
2017;76(2):364-370. doi:10.1136/annrheumdis-2016-209315
10. Reveille JD, Ximenes A, Ward MM, Deodhar A, Clegg D. Economic considerations of the treatment of ankylosing spondylitis. Am J Med Sci. 2012;343(5):371-374. doi:10.1097/MAJ.0b013e3182514093
11. Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A. Ankylosing spondylitis: an overview. Ann Rheum Dis. 2002;61(suppl 3):8iii-18. doi:10.1136/ard.61.suppl_3.iii8