Ankylosing Spondylitis Market (2025 - 2033) Size, Share & Trends Analysis Report By Drug Class (NSAID, TNF Inhibitors), By Distribution Channel (Hospital Pharmacy, Retail Pharmacy), By Region, And Segment Forecasts

Ankylosing Spondylitis Market Summary

The global ankylosing spondylitis market size was estimated at USD 6.29 billion in 2024 and is projected to reach USD 11.08 billion by 2033, growing at a CAGR of 6.4% from 2025 to 2033. The market is growing due to the rising prevalence of inflammatory diseases and greater diagnostic awareness among healthcare providers.

The market is growing due to the rising prevalence of inflammatory diseases and greater diagnostic awareness among healthcare providers. Chronic back pain associated with ankylosing spondylitis is increasing demand for early intervention, supported by advanced imaging techniques such as MRI and CT scans that enable accurate diagnosis at earlier stages. This accelerates treatment initiation and improves long-term outcomes, driving adoption of targeted therapies. For instance, in September 2024, the American Journal of Managed Care reported that the FDA had approved bimekizumab-bkzx (Bimzelx) for adults with AS, nr-axSpA, and PsA, marking the first dual IL-17A and IL-17F inhibitor to secure approval for these indications. Supported by Phase 3 BE MOBILE trials, this milestone expanded therapeutic options and strengthened market growth.

Advancements in biologic therapies are another major factor contributing to market growth. Biologic agents targeting tumor necrosis factor (TNF) and interleukin-17 (IL-17) pathways have transformed the management of ankylosing spondylitis. These therapies reduce inflammation, slow disease progression, and improve quality of life, making them the preferred choice among physicians and patients. For instance, in November 2023, UCB reported at ACR Convergence 2023 that BIMZELX (bimekizumab) delivered sustained five-year improvements in ankylosing spondylitis across disease activity, physical function, and quality of life, with consistent safety. Among 303 patients entering OLE, 202 remained at Week 256, with ASAS40 response rates maintained near 50%. The introduction of biosimilars is also increasing accessibility and affordability, which further expands treatment adoption rates. Pharmaceutical companies actively invest in clinical research to develop novel biologics and small-molecule therapies. Regulatory bodies ' increasing approvals of new drugs give patients and physicians more options.

The rising focus on personalized medicine shapes future opportunities in the market. Genetic testing and biomarker-driven approaches enable more precise selection of therapies tailored to individual patient needs. Such approaches enhance treatment effectiveness and reduce the risk of adverse reactions. The expansion of digital health platforms and telemedicine is improving patient monitoring and adherence to long-term treatment plans. Growing collaborations between pharmaceutical companies and research institutes lead to faster development of innovative treatment options. The global burden of disability linked with ankylosing spondylitis is also pushing demand for advanced therapies that restore mobility and reduce pain. These trends are expected to sustain market growth over the coming years.

Pipeline Analysis

Source: ClinicalTrials.gov

Opportunity Analysis for the Ankylosing Spondylitis (AS) Market

Market Concentration &  Characteristics

The ankylosing spondylitis industry is characterized by a high degree of innovation driven by biologics and targeted therapies. TNF inhibitors such as Humira, Enbrel, and Remicade set the standard for disease management by improving outcomes in patients with severe symptoms. In recent years, IL-17 inhibitors and JAK inhibitors have expanded the treatment landscape, offering new mechanisms of action. Continuous R&D efforts by key players like AbbVie, Novartis, and Eli Lilly fuel the introduction of novel drugs. Companies are investing in biosimilars that offer cost-effective alternatives while maintaining therapeutic efficacy. The rise of precision medicine and biomarker research is shaping a more personalized approach to treatment. These advancements highlight the strong innovation pipeline that sustains the market’s long-term growth. 

The ankylosing spondylitis industry presents significant barriers to entry due to complex R&D requirements and high development costs. Clinical trials for biologics are resource-intensive, with long approval timelines and substantial investment in patient recruitment. Established players such as Pfizer and Johnson & Johnson dominate with extensive product portfolios and strong brand recognition. New entrants face challenges in achieving differentiation due to the presence of highly effective drugs like Simponi and Cimzia. Manufacturing biologics requires advanced facilities and strict compliance with quality standards, further raising the entry threshold. Distribution networks are also firmly established, making it harder for smaller firms to penetrate global markets. As a result, the competitive landscape favors established companies with significant financial and technological resources.

Regulations strongly influence the ankylosing spondylitis industry, especially in drug approval and safety monitoring. Strict clinical trial guidelines ensure that therapies demonstrate proven efficacy and safety before reaching patients. Biologics and biosimilars face additional scrutiny regarding manufacturing standards and long-term monitoring. Regulatory approvals of biosimilars in Europe and the US are expanding patient access while controlling treatment costs. Post-marketing surveillance requirements encourage continuous data collection on adverse effects and effectiveness. Companies like UCB and Merck invest heavily in meeting compliance standards to maintain market presence. Overall, regulations act as both a safeguard for patients and a factor that shapes competitive dynamics.

The market has limited substitutes due to ankylosing spondylitis's chronic and progressive nature. Traditional NSAIDs remain widely used for mild cases but are insufficient in controlling disease progression in advanced patients. Biologics and biosimilars serve as the primary therapeutic option, leaving few viable alternatives outside of these classes. Physiotherapy, exercise, and pain management strategies support treatment but cannot replace pharmacological therapy. Complementary approaches, such as dietary supplements or alternative medicine, have minimal clinical evidence and limited adoption. The reliance on highly specialized drugs reinforces the dominance of established pharmaceutical players. Therefore, substitutes exert only a marginal impact on overall market dynamics.

The ankylosing spondylitis industry shows strong geographical expansion, particularly in emerging economies with rising healthcare infrastructure. North America and Europe remain the leading regions due to high prevalence and access to advanced biologics. Asia Pacific is experiencing rapid growth as countries like China and India improve diagnostic rates and expand treatment availability. Key players target Latin America and the Middle East for market penetration through partnerships and distribution agreements. Biosimilars are driving affordability, enabling greater adoption in cost-sensitive regions. Multinational companies such as AbbVie, Novartis, and Pfizer are strategically expanding clinical trials and commercial operations across diverse geographies. This global expansion ensures broader access to treatment and strengthens long-term market opportunities.

Drug Class Insights

The TNF Inhibitors segment dominated the market with the largest revenue share of 58.70% in 2024, driven by their strong efficacy in controlling inflammation and slowing ankylosing spondylitis progression. Widely used drugs such as Humira, Enbrel, and Remicade remain first-line biologics, backed by extensive clinical evidence, physician confidence, and improved patient outcomes. Broader insurance coverage and high adherence rates further sustain adoption, driven by their ability to relieve pain and stiffness effectively. For instance, in July 2025, Arthritis Research & Therapy reported a real-world study of 148 matched cases showing superior retention for TNF inhibitors compared to IL-17 inhibitors, with three-year rates of 78.5% versus 62.5% and a significant survival advantage (P = 0.034). These findings reinforce their dominant role in treatment.

The non-steroidal anti-inflammatory drug (NSAID) segment is projected to grow at the fastest CAGR of 8.7% over the forecast period, fueled by their role as the first-line treatment for newly diagnosed ankylosing spondylitis patients. NSAIDs are accessible, cost-effective, and convenient, making them a preferred option for symptom relief. Physicians widely recommend them to manage pain and stiffness in early stages, while over-the-counter availability enhances patient self-management. Rising awareness of early intervention further supports prescription growth. For instance, in June 2024, Therapeutic Advances in Musculoskeletal Disease published the Phase IV ASTRUM study showing that secukinumab 150 mg in patients unresponsive to at least two NSAIDs achieved higher ASAS40 and BASDAI50 responses by week 16, with increased NSAID discontinuation rates. This emphasizes their continued clinical relevance.

Distribution Channel Insights

The hospital pharmacy segment dominated the market with the largest revenue share of 47.80% in 2024, which can be attributed to the high administration of biologics and infusion-based therapies in hospital settings. Patients with severe ankylosing spondylitis often require specialized care and monitoring, which is facilitated within hospital environments. Hospital pharmacies ensure immediate availability of advanced biologics such as TNF and IL-17 inhibitors. Physicians prefer prescribing through hospital channels for better compliance and follow-up. The presence of trained healthcare staff supports safe administration and management of potential side effects. Strong supply chains and procurement systems in hospitals further enhance drug accessibility. These factors collectively establish hospital pharmacies as the leading distribution channel in this market.

The retail pharmacy segment is projected to grow at the fastest CAGR of 7.9% over the forecast period, driven by increasing patient preference for convenient access to oral and self-injectable therapies. Patients with stable conditions often shift from hospital care to retail channels for regular refills. The rising availability of biosimilars and affordable generics in retail settings is expanding treatment reach. Retail pharmacies also provide patient counseling and support services that improve adherence. Growing investments in pharmacy networks across urban and semi-urban areas strengthen this segment. Digital ordering and home delivery services are further enhancing patient convenience. These developments position retail pharmacies as a rapidly expanding channel in the market.

Regional Insights

North America held the largest share of the ankylosing spondylitis market in 2024, accounting for 57.32% of global revenue, due to the widespread availability of advanced biologics and biosimilars. The region has a high prevalence of inflammatory conditions, leading to strong demand for targeted therapies. Pharmaceutical companies maintain robust commercial operations supported by well-established distribution networks. Clinical adoption of TNF and IL-17 inhibitors remains strong among specialists treating chronic arthritis. High patient awareness contributes to early diagnosis and consistent treatment adherence. The combination of innovation and accessibility has secured North America’s leadership position in this market.

U.S. Ankylosing Spondylitis Market Trends

The ankylosing spondylitis market in the U.S. represents the largest market within North America, driven by high prescription rates for biologic therapies. A large patient pool with autoimmune diseases ensures steady demand for advanced treatment options. Strong collaborations between research institutes and pharmaceutical companies accelerate drug development. Widespread adoption of self-injectable therapies supports continued growth across outpatient settings. The dominance of key players such as AbbVie, Amgen, and Pfizer reinforces market share. Overall, the U.S. continues to be the central hub for revenue generation in this segment.

Europe Ankylosing Spondylitis Market Trends

The ankylosing spondylitis market in Europe holds a significant share, supported by diverse product availability and growing biosimilar adoption. The region shows a strong clinical preference for TNF inhibitors, which remain the standard of care in several countries. IL-17 inhibitors have also gained traction as alternative therapeutic options. Increasing patient participation in disease awareness programs has enhanced diagnosis rates. Pharmaceutical companies benefit from established healthcare networks for distribution. Europe remains a critical growth contributor through innovation and competitive pricing strategies.

The UK ankylosing spondylitis market is shaped by the rising adoption of biosimilars, which provide cost-efficient treatment. Clinical guidelines favor the use of biologics in patients unresponsive to NSAIDs, which drives demand for advanced therapies. Hospitals are key distribution points for infusion-based treatments, ensuring better patient compliance. Increasing disease awareness has led to earlier referrals to specialists. Growing research collaborations are further improving access to novel biologics. Due to its evolving therapeutic landscape, the UK remains a dynamic European sub-market.

The ankylosing spondylitis market in Germany is leading in the European market, driven by strong pharmaceutical manufacturing capacity and early adoption of biologics. A high number of rheumatologists and specialist clinics ensures access to advanced treatments. The country has been at the forefront of biosimilar adoption, which expands patient reach. Demand is further strengthened by growing recognition of chronic back pain as a key indicator of ankylosing spondylitis. German companies actively participate in clinical research, contributing to pipeline advancements. The market continues to expand steadily due to these structural advantages.

France ankylosing spondylitis market consistently grows due to rising patient consultations for inflammatory disorders. Physicians strongly accept TNF inhibitors and IL-17 therapies in managing severe cases. The country has gradually increased biosimilar uptake, improving treatment affordability. Ongoing educational efforts have enhanced understanding of early disease symptoms. Local pharmaceutical presence supports stable supply and distribution across hospital and retail pharmacies. France remains an important contributor to the regional growth trend in Europe.

Asia-Pacific Ankylosing Spondylitis Market Trends

The ankylosing spondylitis market in the Asia Pacific is expected to register the fastest CAGR of 8.6% over the forecast period, due to a rapidly expanding patient base. Increased recognition of inflammatory back pain leads to higher regional diagnosis rates. Countries are experiencing growing access to biologics and biosimilars, supported by expanding healthcare infrastructure. Pharmaceutical companies are strengthening their presence through partnerships and clinical trials. Rising urbanization and lifestyle-related health risks are contributing to the prevalence of ankylosing spondylitis. These factors collectively position the Asia Pacific as the fastest-growing regional market.

Japan ankylosing spondylitis market is supported by advanced healthcare infrastructure and early availability of biologics. Physicians demonstrate high confidence in prescribing TNF inhibitors for long-term disease control. Strong clinical research activity has led to faster adoption of innovative therapies. Patient adherence is reinforced by structured follow-up systems and specialist clinics. Biosimilars are gradually gaining attention for their affordability and accessibility. Japan remains one of the most developed sub-markets in the Asia Pacific for ankylosing spondylitis.

The ankylosing spondylitis market in China is witnessing rapid market growth due to a large patient population with rising awareness of inflammatory diseases. Diagnostic capabilities are expanding with the wider use of advanced imaging technologies. Biologics and biosimilars are seeing increased uptake as affordability improves across urban areas. Multinational companies are actively expanding clinical trials to strengthen their presence in the Chinese market. Traditional treatment practices coexist, but demand for modern biologics continues to accelerate. China is becoming a key growth engine within the Asia Pacific region.

Latin America Ankylosing Spondylitis Market Trends

The ankylosing spondylitis market in Latin America shows moderate growth potential, driven by improving access to advanced therapies. Brazil and Mexico are the leading contributors, supported by the growing availability of biologics. Awareness campaigns are gradually enhancing recognition of early disease symptoms. Rising participation in clinical studies is expanding access to innovative treatment options. Distribution networks are strengthening across major urban centers. These developments are creating steady opportunities for market expansion in Latin America.

Brazil ankylosing spondylitis market is pivotal in Latin America’s market, supported by its large population base. Growing awareness of inflammatory conditions is leading to earlier medical consultations. Biologic and biosimilar adoption has increased through hospital pharmacies in major cities. Physicians are increasingly recommending targeted therapies for patients unresponsive to NSAIDs. Multinational pharmaceutical companies are expanding their presence in the Brazilian market. These factors collectively establish Brazil as the largest sub-market in the region.

Middle East & Africa Ankylosing Spondylitis Market Trends

The ankylosing spondylitis market in the MEA is expanding gradually, driven by rising diagnosis rates and increasing treatment awareness. Countries in the Gulf region are adopting biologics faster than other parts of the region. Limited specialist availability in certain areas continues to restrict overall adoption. However, expanding private healthcare providers is improving patient access to advanced therapies. The growing prevalence of autoimmune conditions supports steady demand. MEA remains an emerging region with untapped potential for future growth.

Saudi Arabia ankylosing spondylitis market is emerging as one of the strongest markets in MEA for ankylosing spondylitis therapies. Increasing diagnoses of inflammatory spine disorders support the growing demand for biologics. Physicians are widely prescribing TNF inhibitors for severe patient cases. Hospital pharmacies play a central role in ensuring access to advanced therapies. Rising patient awareness is improving long-term treatment adherence. Saudi Arabia’s market is expected to expand steadily in the coming years.

Key Ankylosing Spondylitis Company Insights

AbbVie, Inc. and Amgen, Inc. shape the market with established biologics and strong portfolios in TNF inhibitors. Pfizer, Inc. and Johnson & Johnson, Inc. strengthen their market presence through advanced biologic therapies and extensive patient access. Novartis AG and UCB, Inc. focus on IL-17 inhibitors, driving innovation and expanding treatment options. Eli Lilly and Company and Merck & Co., Inc. advance precision-driven approaches supported by robust immunology pipelines. Zydus Lifescience Ltd. and Izana Bioscience contribute with biosimilars and niche therapies targeting unmet needs. The market expands steadily through innovation, therapeutic diversification, and global strategic development.

Recent Developments

• In March 2025, Pfizer Canada announced that IXIFI, its infliximab biosimilar, would be available in Canada from April 1, 2025. Approved by Health Canada in December 2021, IXIFI covers multiple indications, including ankylosing spondylitis, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriatic arthritis, and plaque psoriasis, expanding affordable biologic access.

• In April 2025, Sandoz filed an antitrust lawsuit in the U.S. against Amgen in Norfolk, Virginia. The complaint alleged that Amgen used a "thicket of patents" to block U.S. entry of Sandoz’s FDA-approved etanercept biosimilar, Erelzi, preserving Enbrel’s USD 3.3 billion 2024 revenue and denying access to approximately 7.5 million patients.

• In October 2024, Johnson & Johnson announced it had assumed UK commercialization of Remicade (infliximab) and Simponi (golimumab) from Merck Sharp & Dohme. Remicade treats conditions including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, and psoriasis, while Simponi is indicated for arthritis, axial spondyloarthritis, and ulcerative colitis.

Ankylosing Spondylitis Market Report Scope

Global Ankylosing Spondylitis Market Report Segmentation

This report forecasts revenue growth at global, regional, and country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2021 to 2033. For this study, Grand View Research has segmented the global ankylosing spondylitis market report based on drug class, distribution channel, and region:

• Drug Class Outlook (Revenue, USD Million, 2021 - 2033)

  • Non-Steroidal Anti-Inflammatory Drug (NSAID)

  • TNF Inhibitors

    • Humira

    • Simponi

    • Remicade

    • Enbrel

    • Cimzia

    • Other TNF Inhibitors

  • Other Drug Classes

• Distribution Channel Outlook (Revenue, USD Million, 2021 - 2033)

  • Hospital Pharmacy

  • Retail Pharmacy

  • Others

• Regional Outlook (Revenue, USD Million, 2021 - 2033)

  • North America

    • U.S.

    • Canada

    • Mexico

  • Europe

    • UK

    • Germany

    • France

    • Italy

    • Spain

    • Denmark

    • Sweden

    • Norway

  • Asia Pacific

    • Japan

    • China

    • India

    • Australia

    • South Korea

    • Thailand

  • Latin America

    • Brazil

    • Argentina

  • Middle East & Africa

    • South Africa

    • Saudi Arabia

    • UAE

    • Kuwait