This protocol applies to patients with ankylosing spondylitis who have peripheral arthritis — predominantly peripheral joint manifestations alongside the underlying spondyloarthritis.
An initial treatment course — NSAIDs at up to the maximum tolerated dose (used continuously as needed), alongside physiotherapy, regular exercise, education about axSpA, and smoking cessation — failed to achieve the required goal: control of back pain and spinal stiffness within 2–4 weeks.
This protocol represents the structured next step after that failure.
For patients with peripheral arthritis, a conventional disease-modifying therapy is among the options considered — with specific eligibility criteria and, where clinically appropriate, a targeted local intervention at the affected site.
Full regimen, clinical decision criteria, and sequencing are available in the complete protocol…