Recent advances in biologic therapies for ankylosing spondylitis: A 2024 update

BACKGROUND: Ankylosing spondylitis (AS), a long-term autoimmune disorder characterized by systemic inflammation, manifests as gradually worsening arthritis predominantly affecting the spinal column and sacroiliac joints. While emerging biologic agents have broadened treatment possibilities, their clinical application raises notable safety considerations. OBJECTIVE: To comprehensively summarize recent advancements in bDMARD applications (including tumor necrosis factor-alpha inhibitors (TNFi), interleukin 17 inhibitors (IL17i), and Janus kinase inhibitors (JAKi)) for AS management. MATERIAL AND METHODS: A thorough bibliographic search was conducted to identify studies meeting the inclusion criteria in the Pubmed (MEDLINE) and EMBASE databases in July 2025 for nearly a year. Our search strategy included both medical subject headings (MeSH) and free text terms relevant to the biologics. RESULTS: A total of 147 studies were screened and 37 clinical studies were ultimately selected in this review, drawing on peer-reviewed studies released within the previous calendar year. Adalimumab, infliximab, etanercept, golimumab, certolizumab pegol, secukinumab, bimekizumab, ixekizumab, tofacitinib, upadacitinib, and baricitinib had greater remittance in AS, with some side effects. CONCLUSION: This comprehensive analysis assesses therapeutic outcomes and adverse effects of TNFi, IL17i, and JAKi in AS care.