Efficacy and Safety of Iguratimod Combined with Yunke Injection in the Treatment of Ankylosing Spondylitis

Background Biologics and Janus kinase (JAK) inhibitors carry specific risks for Ankylosing Spondylitis patients at risk of tuberculosis infection or those with contraindications such as a history of cancer, there is an urgent need to explore safe and effective alternative treatment options. Aims To evaluate the efficacy and safety of Iguratimod combined with Yunke injection in the treatment of ankylosing spondylitis at risk of tuberculosis infection or those with a history of cancer. Study Design Retrospective cohort study. Methods A retrospective study was conducted on 48 patients with ankylosing spondylitis who had received treatment over the past 3 years and had a history of tuberculosis infection or malignancy. Their treatment regimens and therapeutic outcomes were analyzed, with particular attention to the progression of tuberculosis and malignancy. Results There was 30 patients receiving Iguratimod combined with Yunke injection treatment, and non-steroidal anti-inflammatory drugs (NSAIDs) were added when pain was severe,referred to as the observation group; 18 patients took Iguratimod and NSAIDs, referred to as the contral group. After treatment of 24 months, both groups showed significant improvements in 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), and overall levels could achieve low disease activity. However, the improvement of observation groupin was better than that in the control group, P<0.05. Moreover, the use of NSAIDs in the observation group was significantly less than that in the control group, P<0.001. Conclusion This study shows that Iguratimod combined with Yunke injection has good efficacy in patients with ankylosing spondylitis who cannot use biologics or JAK inhibitors, not only alleviating pain and morning stiffness but also slowing radiographic progression and reducing the dose of NSAIDs. The combination has a synergistic effect and does not increase adverse reactions. This therapy provides a novel option for patients with specific ankylosing spondylitis.