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For very high disease activity, you may even go right to an IL-17 blocker and bypass anti-TNFs, which have not proven as effective for ankylosing spondylitis as they have been for other types of inflammatory arthritis
Nasal delivery provides a direct pathway to the brain, allowing peptides to reach their target without having to cross the BBB

J Immunol (2009) 183:35617.10.4049/jimmunol.0800933 63 KrumbholzMTheilDDerfussTRosenwaldASchraderFMonoranuC-Met alBAFF is produced by astrocytes and up-regulated in multiple sclerosis lesions and primary central nervous system lymphoma
