The drug secukinumab was developed to treat spondyloarthritis, an umbrella term for a range of conditions in which, for reasons unknown, the immune system turns inward and attacks healthy spinal joints

People with severe back pain are to be given a new drug that can stop the disease and protect against permanent spinal damage.

Until now, effective treatment – a self-administered injection – has been reserved for the most advanced diseases. But starting this week, the NHS will get the green light to offer the DIY jabs for those in the early stages.

The drug secukinumab was developed to treat spondyloarthritis, an umbrella term for a range of conditions in which, for reasons unknown, the immune system turns inward and attacks healthy spinal joints.

The drug secukinumab was developed to treat spondyloarthritis, an umbrella term for a range of conditions in which, for reasons unknown, the immune system turns inward and attacks healthy spinal joints

With both types, the main symptom is back pain and stiffness, which worsen after inactivity and decrease after exercise.  Patients often suffer more at night, leading to disturbed sleep and stiffness in the morning.  Eye and bowel problems and fatigue are other symptoms

With both types, the main symptom is back pain and stiffness, which worsen after inactivity and decrease after exercise. Patients often suffer more at night, leading to disturbed sleep and stiffness in the morning. Eye and bowel problems and fatigue are other symptoms

Secukinumab is available in pre-filled single-dose “pens”.  Each pen costs around £ 600 privately.  So if a patient were to pay for the treatment themselves, it would cost around £ 10,000 a year for the first year and £ 7,200 a year thereafter

Secukinumab is available in pre-filled, single-dose injector pens. Each pen costs around £ 600 privately. So if a patient were to pay for the treatment themselves, it would cost around £ 10,000 a year for the first year and £ 7,200 a year thereafter

This leads to inflammation, stiffness and pain and, in the long term, damage to the spine itself.

The disease has two main subtypes: non-radiographic axial spondyloarthritis, where x-rays do not show damage to the spine, and ankylosing spondylitis, where the damage is visible.

With both types, the main symptom is back pain and stiffness, which worsen after inactivity and decrease after exercise. Patients often suffer more at night, leading to disturbed sleep and stiffness in the morning. Eye and bowel problems and fatigue are other symptoms.

More than 200,000 Britons are affected by these conditions and most are starting problems in their 20s.

Historically, spondyloarthritis has been difficult to detect before the damage was visible on x-rays, and there is currently an average delay of eight years in diagnosis from the onset of symptoms.

Advances in scanning techniques and testing mean spondyloarthritis can now be detected at an earlier stage. However, many patients hesitate to seek help because back pain is such a common complaint. Buttock pain is often initially misdiagnosed as sciatica, a condition caused by compressed nerves in the lower back. In about half of the cases, the non-radiographic axial spondyloarthritis progresses to ankylosing spondylitis.

Secukinumab, also known under the brand name Cosentyx, is already being used in patients with ankylosing spondylitis.

Studies showed that 45 percent of patients who received secukinumab saw significant improvement in symptoms, including less pain and stiffness, after 16 weeks of treatment. Now, the National Institute for Health and Care Excellence (NICE) Prescription Guard has approved secukinumab for use in patients with non-radiographic axial spondyloarthritis.

Known as biological therapy, the drug works by disrupting the proteins produced by the immune system that cause inflammation. This leads to long-term relief. The consulting rheumatologist Dr. Raj Sengupta of Bath’s Royal National Hospital for Rheumatic Diseases said, “We know that the pain and suffering of patients with the non-radiologic form of the early-stage disease can be as severe as this.” in the later stages.

Studies showed that 45 percent of patients who received secukinumab saw significant improvement in symptoms, including less pain and stiffness, after 16 weeks of treatment

Studies showed that 45 percent of patients who received secukinumab saw significant improvement in symptoms, including less pain and stiffness, after 16 weeks of treatment

“The hope is that the response rate will be better and we will have more chances of slowing irreversible spinal damage if we can get treatment to the right patients sooner.”

He added, “These are terrible disabling conditions and secukinumab is giving patients back their quality of life. Many of them call it a “miracle drug”.

Dr. Sengupta supports a new National Axial Spondyloarthritis Society campaign aimed at reducing time to diagnosis to one year. He says, “If patients and GPs recognize the characteristic symptoms while reading – back pain and stiffness that get worse at rest and get better after being active, waking up at night with pain and morning stiffness – they should see a rheumatologist immediately” so that we can do tests can.’

It is believed that spondyloarthritis is caused by a problem with the immune system. Treatment includes one injection once a week for five weeks, followed by a single syringe once a month.

Secukinumab is available in pre-filled, single-dose injector pens. Each pen costs around £ 600 privately. So if a patient were to pay for the treatment themselves, it would cost around £ 10,000 a year for the first year and £ 7,200 a year thereafter.

However, NICE is negotiating special “bulk discount” offers, which means the NHS is likely to pay far less.

One patient who has already seen the benefits of the treatment is 42-year-old businesswoman Clair McGrath. She suffered life-saving back pain for 12 years before being diagnosed with non-radiographic axial spondyloarthritis in 2016.

Clair says, “When I was 25, after my daughter was born, I started having lower back pain. At first the doctor thought it was pregnancy related and was told it was going to go away. But it didn’t. The pain was particularly bad at night – so bad that I sometimes slept on the floor. “

Eventually, with extreme fatigue and pelvic pain, Clair returned to her family doctor and was referred to a rheumatologist who diagnosed her. A year later, she was given secukinumab and the transformation was remarkable.

“The most important change for me is that the tiredness is gone,” she says. “I feel sharper and have more stamina. I could start swimming.

“When I started taking it, I thought, ‘This is how it must feel to be normal.’ I forgot because I had been sick for so long. ‘