How can I effectively monitor disease progression and treatment response in patients with ankylosing spondylitis?

Effective monitoring of disease progression and treatment response in patients with ankylosing spondylitis involves regular assessment of disease activity, progression, and response to treatment, tailored to individual clinical features, comorbidities, and psychosocial factors ¹.

This includes using patient-reported outcomes, clinical findings, laboratory tests, and imaging such as MRI of the sacroiliac joints or spine when necessary, especially if physical and laboratory tests are normal despite active disease ¹.

Follow-up should be individualized, with reassessment intervals typically every 3–6 months, especially after initiating or changing treatment, and should include assessment of symptoms like pain, stiffness, and fatigue, as well as functional impact ¹.

Monitoring should also include evaluation of adverse effects of medications, assessment of cardiovascular and osteoporosis risks, and detection of extra-articular manifestations such as uveitis ¹.

Specialist tests like MRI are recommended to assess disease activity when X-ray findings are inconclusive or in early disease stages ¹.

In patients on biological DMARDs, ongoing response should be confirmed before continuing treatment, with treatment continuation only if there is clear evidence of response ¹.