Основные принципы терапии анкилозирующего спондилита (болезни Бехтерева)

The history of treatment of ankylosing spondylitis (AS) and the reasons behind the development of modern approaches to its therapy are briefly described. The main tasks and principles of non-pharmacological and drug therapies for AS are briefly reported. The need for therapeutic physical training is emphasized, since its role in maintaining the functional status in this group of patients has been proved. The lecture casts doubt on effectiveness of physiotherapy and other physical techniques because of the poor evidence base. The lecture emphasizes the disease-modifying role of nonsteroidal anti-inflammatory drugs and requirement to receive them constantly for patients with Bechterew's disease. Meanwhile, the basic anti-inflammatory drugs in patients with this disease are reported to play an auxiliary role and to have no effect on disease progression. The pronounced clinical effectiveness of all tumor necrosis factor α inhibitors is emphasized; certain differences in their therapeutical effect are described. The problems of surgical treatment, which deal with correction of disease complications or undesirable effects, are discussed.