Clinical Trials for Ankylosing Spondylitis
Ankylosing spondylitis (AS) -- now often referred to as radiographic axial spondyloarthritis -- is a chronic inflammatory arthritis that primarily affects the spine and sacroiliac joints, causing pain, stiffness, and over time, fusion of vertebrae. It can also affect other joints and organs. Treatment has improved substantially with biologics, but access to these treatments is frequently blocked by insurance prior authorization and denial.
Clinical trials for ankylosing spondylitis and related axial spondyloarthritis conditions are active and studying newer, more selective treatments.
The Spondylitis Association of America estimates that as many as 2.7 million Americans live with ankylosing spondylitis and related conditions.
What Types of Trials Are Available?
IL-17 inhibitor trials represent one of the most active areas in AS research, building on the success of secukinumab (Cosentyx) and ixekizumab (Taltz). Next-generation IL-17 agents are in development. JAK inhibitor trials study oral options like tofacitinib and upadacitinib, which are approved for AS and for which newer agents are still in trials. TNF inhibitor trials continue to study new agents and optimal dosing strategies in this long-established therapeutic class. Non-radiographic axial spondyloarthritis (nr-axSpA) trials specifically study people with inflammatory axial disease that does not yet show structural changes on X-ray -- a distinct diagnosis with its own trial landscape.Search ClinicalTrials.gov for currently recruiting trials.
Am I Eligible?
Common eligibility factors for AS trials include:
- Confirmed AS diagnosis (meeting modified New York criteria) or nr-axSpA diagnosis
- Active disease (BASDAI or ASDAS score above a threshold)
- Elevated CRP or active sacroiliitis on MRI
- Prior treatment with NSAIDs (most trials require documented inadequate response to NSAIDs)
- Prior biologic history if the trial is designed for biologic-naive or biologic-experienced participants
Bring your imaging reports and inflammatory marker history to the conversation with your rheumatologist. Talk to your doctor before making any decisions about your treatment.
What If My Insurance Denied My Medication?
Biologics for ankylosing spondylitis -- including adalimumab (Humira), secukinumab (Cosentyx), and others -- are commonly subject to step therapy requirements, which often force you to try older TNF inhibitors before insurers will approve IL-17 blockers. If your rheumatologist has a clinical reason for starting you on a specific agent and your insurer has said no, that decision can be challenged.
While your appeal moves forward, a clinical trial studying a similar or newer mechanism may offer access to treatment. Many people find that their treatment history -- including a prior denial -- maps directly onto the eligibility profile of available trials.
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Frequently Asked Questions
Are clinical trials for ankylosing spondylitis free?
In most cases, yes. Trial sponsors (pharmaceutical companies, universities, or the NIH) cover the cost of the experimental treatment. You may still have costs for routine care — like doctor visits or standard tests — depending on your insurance. Always ask the trial coordinator what costs you might be responsible for before enrolling.
How do I find ankylosing spondylitis trials near me?
The best place to start is ClinicalTrials.gov, the official registry of all trials in the US. Search by condition name and filter by your location. Your specialist can also help identify trials at academic medical centers in your region.
Can I join a trial after being denied Cosentyx or Humira?
Yes, and in many cases a denial can actually make you a stronger candidate — trials often enroll patients who have not responded to or cannot access standard treatments. Talk to your doctor about whether your denial history makes you eligible for open trials studying Cosentyx or Humira or similar medications.