Is methotrexate effective for axial disease in AS?

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Prepare for the CMS II Rheumatology E1 Exam with our comprehensive quiz. Study using flashcards and multiple-choice questions, each with hints and explanations. Get ready for success!

Multiple Choice

Is methotrexate effective for axial disease in AS?

Explanation:
Methotrexate does not effectively treat inflammation of the spine and sacroiliac joints in ankylosing spondylitis. In axial disease, randomized trials and analyses have shown little to no meaningful improvement in back pain, morning stiffness, or overall disease activity with MTX, so it isn’t considered effective for the spine. The place for methotrexate in AS is mainly for peripheral arthritis or enthesitis, not for axial symptoms. For axial disease, guidelines favor NSAIDs and, when needed, biologic therapies such as TNF inhibitors or IL-17 inhibitors.

Methotrexate does not effectively treat inflammation of the spine and sacroiliac joints in ankylosing spondylitis. In axial disease, randomized trials and analyses have shown little to no meaningful improvement in back pain, morning stiffness, or overall disease activity with MTX, so it isn’t considered effective for the spine. The place for methotrexate in AS is mainly for peripheral arthritis or enthesitis, not for axial symptoms. For axial disease, guidelines favor NSAIDs and, when needed, biologic therapies such as TNF inhibitors or IL-17 inhibitors.

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