Q: I am suffering from ankylosing spondylitis for last 6 months. It was diagnosed after bone scan and MRI of sacrolliac joint. My doctor has initially given me Predmet 4 and later stopped it saying it will have side effects. But I responded to Predmet 4 very well initially and later a new drug Lefra was started. My doctor has now suggested to go for Anti-TNF agents (infliximab and etanercept)treatment. He also cited that its success rate among the patients is 60-70% and it can flare up dormant TB also. Kindly advise me whether or not to go in for this treatment?

A:Lefra does not have a significant role in this situation. Anti TNF therapies are potent. They do carry a risk of TB. It is essential to rule out hidden TB before starting therapy. Nevertheless, even if that is not there, you still run a risk of acquiring the disease. At the same time, since many other options do not exist, this form of treatment remains a good choice.