Ankylosing Spondylitis CONDITION GUIDE

Ankylosing Spondylitis CONDITION GUIDE

Ankylosing spondylitis CONDITION GUIDE 1 Introduction and how to use this guide ����������������������������������������� 1 Understanding ankylosing spondylitis ���������������������������������������� 3 What is AS? ������������������������������������������������������������� 4 Who is affected? ��������������������������������������������������������� 4 What are the symptoms? ������������������������������������������������� 5 What are the risk factors? ������������������������������������������������� 5 Taking care of your body ����������������������������������������������������� 6 Staying mobile with AS ��������������������������������������������������� 7 Eating healthy ���������������������������������������������������������� 7 Exercising regularly ������������������������������������������������������ 8 Practice good posture ���������������������������������������������������� 8 Sleeping well ����������������������������������������������������������� 9 Smoking ��������������������������������������������������������������� 9 Maintaining a healthy weight ��������������������������������������������� 9 Lifestyle approaches ���������������������������������������������������� 10 Supporting your emotional health ���������������������������������������� 10 AS treatment approaches ��������������������������������������������������� 12 Staying on track with your medicines ������������������������������������� 13 Treatment strategies and goals ������������������������������������������� 14 Administering your medicine ��������������������������������������������� 14 Injection-site reactions �������������������������������������������������� 14 Medicines for AS ������������������������������������������������������� 15 Complementary and alternative medicine ���������������������������������� 17 The future is bright ����������������������������������������������������� 17 Understanding side effects �������������������������������������������������� 18 Possible side effects ���������������������������������������������������� 19 Nausea and diarrhea ���������������������������������������������������� 20 When it’s time to call your health care provider ����������������������������� 20 Resources and References �������������������������������������������������� 22 Resources ������������������������������������������������������������� 22 References ������������������������������������������������������������ 24 2 INTRODUCTION AND HOW TO USE THIS GUIDE How to use this guide We know the diagnosis of ankylosing spondylitis (AS) can be overwhelming. This guide can help answer concerns, while giving you or your child important information to share with family or friends. Your health care provider has suggested that you or your child start treatment. This means that your health care provider believes you or your child has a good chance of responding to medicine. We’re here to help, every step of the way. Remember that taking your medicine as prescribed will help you or your child lead a healthy life. Please do not stop taking your medicine without checking with your health care provider. Health care providers have learned how to individualize treatment so that each patient has the best chance of responding. The treatment you or your child receives may differ from the treatment of other patients with ankylosing spondylitis. This is one of the reasons it is so important that you talk about any questions or concerns you may have with your health care provider or with a Prime Therapeutics Specialty Pharmacy™ (Prime Specialty Pharmacy) nurse or pharmacist. Personal support can help make a challenging journey easier 24/7 ACCESS Visit us online MyPrime.com/Specialty A pharmacist is always available to answer questions 877.627.6337 ( T T Y 711) 1 INTRODUCTION AND HOW TO USE THIS GUIDE There are four parts to this guide 1 Understanding your ankylosing spondylitis We’re here to help you become better informed. In this chapter, we’ll discuss how to live your best life with a diagnosis of ankylosing spondylitis. 2 Taking care of your body Find ways to take charge of your health — both physically and mentally — with proactive changes. 3 AS treatment approaches Want to learn more about what treatment approaches that your health care provider or the Prime Specialty Pharmacy care team might suggest? We’ll go over possible treatment plans, including medicine and other ways to help manage ankylosing spondylitis in a way that works best for your or your child’s lifestyle. 4 Understanding side effects Learn tips to help reduce side effects, and know when to call your health care provider. 2 Understanding ankylosing spondylitis Did you know that approximately 500,000 people in the United States have ankylosing spondylitis?1 Whether you or your child is newly diagnosed or has been living with AS for a while, this guide is all about helping you become better informed about AS and your options for staying healthy. 3 UNDERSTANDING AS What is ankylosing spondylitis? You are not alone Symptoms vary from mild to severe Ankylosing spondylitis is a chronic (long-term) disease and in young adults with AS. Some is a form of progressive arthritis. It results in inflammation individuals have no symptoms at of the spinal joints. The joints at the base of the spine, all (remission). One of the most where the spine meets the pelvis, are also affected. Over important reasons to continue time, ankylosing spondylitis can cause the affected spinal treatments, even if you feel fine, bones to grow together (fuse). This can limit the movement is that AS can continue to affect and flexibility of the spine and may affect posture and the your body over time. function and capacity of your lungs.2 It may also cause inflammation in your eyes and other parts of your body.3 Ankylosing spondylitis cannot be prevented, but early recognition of symptoms may make treatment more successful. Most people with ankylosing spondylitis can live full, productive lives. Who is affected? AS usually develops first in adolescents and young adults and is more common in boys2 and Caucasian, Asian and Hispanic populations.1 4 What are the symptoms? The course of ankylosing spondylitis is difficult to predict; it varies for each individual. Some may have mild symptoms while others may have severe back pain.2 Ankylosing spondylitis causes inflammation (swelling) of the joints in the spine and the pelvis. Initially, the symptoms may come on gradually. Early symptoms include pain and stiffness in the lower back — between the pelvis and the spine — that comes and goes. The pain and stiffness may feel worse first thing in the morning, at night or after periods of inactivity, and improves with exercise or activity.2 Over time, other areas of the spine may be affected. As the disease progresses, the body attempts to heal by forming new bone matter. The new bone forms over the space between spinal bones, causing them to join — or fuse — together. This causes those areas of the spine to stiffen and become less flexible and may cause a person’s posture to lean forward or “stoop.” In some people, this can become disabling. Also, there can be inflammation in the regions where ribs meet the spine or the breastbone. This may make it more difficult to expand your chest and breathe. Fatigue is also a common symptom.2 Less common symptoms include: → Inflammation of the eye, bowel and more rarely, the heart and lungs2 → Thinning of the bones3 → Pain in the feet or heel2 → Pain and swelling in the shoulders, knees and sites where the tendons and ligaments attach to the bones2 → Pain and stiffness in the hips2 → Mild fever and loss of appetite1 What are the risk factors? The cause of ankylosing spondylitis is not known; however, genetics seem to play a role. People who have a gene that produces a specific genetic marker (a protein called HLA-B27) are at greater risk for developing ankylosing spondylitis.2 The risk factors for ankylosing spondylitis include genetics, gender and family history. In contrast to other types of joint disease, males show a greater risk for developing it than females. People with a family history of the disease are also at higher risk. It typically begins between the ages of 17 and 35, but it can occur earlier as well.1 Frequent gastrointestinal infections can also be a risk factor for AS.2 5 Taking care of your body Fortunately, there are ways you or your child can lessen the physical and mental health stress by being proactive in a few areas. This includes lifestyle habits to cope with the symptoms of AS and maintaining a healthy diet, regular exercise, a smart sleep schedule and a great support network. 6 Staying mobile with AS AS can cause permanent stiffness with changes in mobility, sometimes affecting balance and coordination. For our bodies to stay in balance, we need our eyes, ears, brain, sense of body position and perceptions. Ask your health care provider if physical or occupational therapy would be appropriate for you. Eating healthy Most children do not have specific dietary needs or restrictions and there is no specific diet that can cure AS. Some children may experience weight loss due to difficulty chewing if they have an affected jaw. Other children may experience weight gain due to limitations on their mobility or side effects from certain medicines. The most important things are to eat healthy and maintain a healthy weight. A balanced diet includes plenty of fruits, vegetables and whole grains. It also limits salt, sugar, and saturated fat. Invest the time to learn how to improve

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