Case report describes the patient with severely ongoing ankylosing spondylitis. Introduced TNF inhibitors therapy must to be discontinued: in two drugs for primary failure and three others for secondary failure after 12-48 months.
After the application of available TNF inhibitor molecules, the patient was converted to therapy by the IL-17A inhibitor secukinumab. This treatment has achieved a still-lasting favorable response.
A switch of therapy for molecule with another mechanism of action can lead to a positive response even after multiple failures of TNF alpha inhibitors.