New drug combo helps ankylosing spondylitis patients with tuberculosis or cancer history

Ankylosing spondylitis is a chronic inflammatory disease that can cause pain, stiffness and long-term damage to the spine. Many of the most effective modern therapies — notably biologics and Janus kinase (JAK) inhibitors — may be risky for people who have a history of tuberculosis infection or cancer, leaving doctors and patients with fewer safe options. To explore alternatives, a team led by corresponding author zhang shiyu reviewed the medical records of patients treated over the past three years who had ankylosing spondylitis and a past history of tuberculosis infection or malignancy. The goal was to evaluate whether a combination of two therapies, Iguratimod and Yunke injection, could work safely and effectively in this particular group. Because these patients are often excluded from trials of biologics and JAK inhibitors, the researchers used a retrospective cohort approach to look back at real-world outcomes and monitor whether the combination controlled disease activity without worsening tuberculosis or cancer-related concerns.

The study analyzed 48 patients with ankylosing spondylitis who had received treatment over the prior three years and had a history of tuberculosis infection or malignancy. Patients were split into two groups: an observation group of 30 patients who received Iguratimod combined with Yunke injection (with non-steroidal anti-inflammatory drugs, NSAIDs, added when pain was severe), and a control group of 18 patients who took Iguratimod with NSAIDs. Outcomes were tracked for 24 months and included Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Both groups showed significant improvements across ASDAS, BASFI, mSASSS, ESR, and CRP, reaching overall low disease activity. The observation group improved more than the control group (P<0.05), and its use of NSAIDs was significantly lower (P<0.001). The combination slowed radiographic progression as reflected in mSASSS and did not increase adverse reactions.

These findings indicate that combining Iguratimod with Yunke injection may offer a practical alternative for patients with ankylosing spondylitis who cannot take biologics or Janus kinase (JAK) inhibitors because of tuberculosis risk or a history of cancer. According to the study, the combination not only reduced pain and morning stiffness but also slowed radiographic progression of the spine and cut the need for NSAIDs, suggesting a synergistic effect between Iguratimod and Yunke injection. Importantly, the retrospective review did not find an increase in adverse reactions, and the researchers paid particular attention to any progression of tuberculosis or malignancy among participants. While this work describes outcomes in a specific, real-world group of patients, it provides a novel treatment option to consider when standard immune-suppressing therapies are not safe or appropriate.