Ankylosing spondylitis is an inflammatory arthritis that primarily affects the spine and sacroiliac joints, causing pain and stiffness that's often worst in the morning. It affects roughly 1 in 200 people and typically starts in young adults. Treatment centers on TNF inhibitors, IL-17 inhibitors, and JAK inhibitors, which have transformed outcomes over the past two decades.
What's actually going on in research
Current trials are testing oral JAK inhibitors that may offer an alternative to injections, new IL-17 pathway drugs, and combinations that target multiple inflammatory signals. Researchers are also studying early intervention before spinal damage occurs, treatments for extra-spinal manifestations like uveitis and inflammatory bowel disease, and biomarkers that predict which drug will work best for each person.
JAK inhibitors
Upadacitinib was FDA-approved for ankylosing spondylitis in 2022, offering the first daily pill option that matches injection effectiveness. Other JAK inhibitors are in trials, potentially expanding oral treatment choices.
Early treatment
Studies are testing whether starting biologics at the first signs of disease can prevent spinal fusion. If successful, this could shift treatment to much earlier in the disease course.
IL-17 pathway expansion
Beyond secukinumab and ixekizumab, new IL-17 blockers are in development. Some target different parts of the IL-17 pathway and may work for people who haven't responded to existing options.
What to know before you search
Eligibility typically depends on disease activity scores, response to NSAIDs, prior biologic use, and presence of active inflammation on MRI or blood tests showing elevated CRP.
What types of trials are currently open
- Treatment trials — Testing new biologics or JAK inhibitors against placebo or existing drugs to measure pain reduction, stiffness, and inflammation on MRI.
- Head-to-head trials — Comparing different drug classes directly to see which works better for specific patient groups.
- Early intervention trials — Starting treatment in people with non-radiographic axial spondyloarthritis, before X-rays show damage, to see if progression can be stopped.
- Combination trials — Testing whether combining drugs that target different pathways works better than single drugs.
- Uveitis prevention trials — Studies focused on preventing or treating the eye inflammation that affects up to 40% of people with ankylosing spondylitis.
Recently added Ankylosing Spondylitis trials
A Study of HB0017 Injection in Healthy Volunteers to Evaluate Safety and Tolerability of a Single Subcutaneous Injection in Low-Body-Weight Subjects; and Pharmacokinetics at Different Subcutaneous Injection Sites at the Same Dose
The goal of this clinical trial is to (PART 1) to evaluate the safety and tolerability of a single subcutaneous injection of HB0017 Injection in healthy subjects with low body weight; ( PART 2) to compare the pharmacokinetics (PK) of HB0017 following single subcutaneous administration at different injection sites at the same dose.
Phase Ia Study of MST-931 in Healthy Adult Subjects
A Phase 1a, randomized, double-blind study of MST-931 in healthy participants. The purpose of this research is to investigate the safety, tolerability, pharmacokinetics, pharmacodynamics, and immunogenicity of a single subcutaneous dose of MST-931 given to healthy participants. MST-931 is a monoclonal antibody.
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