Enbrel (TNF-alpha blocker) | Etanercept | 25-50 mg | Once weekly | 50 mg/week | Subcutaneous injection | Yes. Also approved for psoriatic arthritis and juvenile idiopathic arthritis. | Not effective in colitis associated with AS.
Not as effective in iritis associated with AS.
May reduce spinal fusion. |
Remicade (TNF-alpha blocker) | Infliximab | 3-10 mg/kg | Every 4-8 weeks | 200-800 mg every 4-8 weeks | Intravenous infusion | Yes. Also approved for psoriatic arthritis. | Effective for AS patients with co-existing colitis and iritis.
Has a mouse protein as part of drug molecule which can cause infusion reactions.
May reduce spinal fusion. |
Humira (TNF-alpha blocker) | Adalimumab | 40 mg | Every 2 weeks | 40 mg | Subcutaneous injection | Yes. Also approved for psoriatic arthritis and juvenile idiopathic arthritis. | Effective for AS patients with co-existing colitis and iritis.
May reduce spinal fusion. |
Simponi (TNF-alpha blocker) | Golimumab | 50 mg | Every 4 weeks | 50 mg | Subcutaneous injection | Yes. Also approved for psoriatic arthritis. | Effective for AS patients with co-existing colitis and iritis.
May reduce spinal fusion. |
Simponi Aria (TNF- alpha blocker) | Golimumab | 2 mg/kg | Baseline, at 4 weeks, then every 8 weeks | 50-150 mg/8 weeks | Intravenous infusion | Yes. Also approved for psoriatic arthritis. | Effective for AS patients with co-existing colitis and iritis.
May reduce spinal fusion. |
Cimzia (TNF-alpha blocker) | Certolizumab pegol | 200-400 mg | Every 4 weeks | 400 mg monthly | Subcutaneous injection | Yes. Also approved for psoriatic arthritis and non-radiographic axial spondyloarthritis. | Effective for AS patients with co-existing colitis and iritis.
May have less hematological side-effects. Does not cross placental barrier.
May reduce spinal fusion. |
Cosentyx (Interleukin 17 blocker) | Secukinumab | 150-300 mg | 150 mg weekly × 4 weeks loading dose, then 150 mg every 4 weeks | 150 mg | Subcutaneous injection | Yes. Also approved for psoriatic arthritis and non-radiographic axial spondyloarthritis. | Loading and maintenance dose of 300 mg if there is co-existing moderate to severe psoriasis.
New onset of or flare-up of Crohn’s or colitis bears caution. |
Taltz (Interleukin 17 blocker) | Ixekizumab | 160 mg, then 80. | 160 mg loading dose, then 80 mg every 4 weeks. | 80 mg | Subcutaneous injection | Yes. Also approved for psoriatic arthritis and non-radiographic axial spondyloarthritis. | Used for spinal inflammation & peripheral arthritis in AS. May contribute to new onset of or flare-up of Crohn’s or colitis. |