19th January 2024

A 25-year-old female presents with worsening back pain and stiffness over the past few months, on a background of ankylosing spondylitis.

A 25-year-old female presents with worsening back pain and stiffness over the past few months, on a background of ankylosing spondylitis. Initially, she was able to control the pain with exercise and ibuprofen; however, this has recently failed to control her symptoms. She has no other past medical history; however, she has been suffering from depression due to the pain and inability to carry out her daily tasks, such as cooking and cleaning. She has a 2-year-old daughter and does not want any more children.

What is the most appropriate second-line treatment for this lady?

Select the SINGLE most appropriate option from the list below. Select ONE option only.