New Treatments & Clinical Trials for Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that primarily targets the spine and sacroiliac joints, causing progressive pain, stiffness, and in severe cases fusion of vertebrae. It typically begins in young adults and is strongly associated with the HLA-B27 gene. Without effective treatment, spinal mobility can be severely restricted over time.

What's actually going on in research

TNF inhibitors and IL-17 inhibitors (secukinumab, ixekizumab) are now well-established treatments that significantly reduce inflammation and improve function in active AS, and both classes have demonstrated benefits for radiographic progression. JAK inhibitors such as upadacitinib are now also approved and offer an oral alternative. Trials are exploring IL-23 inhibitors, which showed mixed initial results in AS despite effectiveness in related conditions, as well as biomarker-driven approaches to personalize therapy selection.

What to know before you search

Eligibility typically requires confirmed axial spondyloarthritis diagnosis, active disease despite NSAIDs, and no prior or current use of the specific biologic being studied.

What types of trials are currently open

• JAK inhibitor trials — Comparing oral JAK inhibitors to biologics in active ankylosing spondylitis across diverse patient populations.
• Biologic therapy trials — Testing new IL-17 and IL-23 pathway inhibitors and combination strategies in active disease.
• Early intervention studies — Evaluating whether prompt treatment delays radiographic spinal fusion in newly diagnosed patients.
• Treat-to-target trials — Assessing structured remission-targeting approaches versus standard symptom management.
• Biomarker studies — Identifying imaging and blood markers to predict treatment response and disease progression.