• Some biologic drugs for spondylitis can be self-injected at home.
• There are different types of self-injection, including prefilled syringes, self-injection pens, and electronic devices, also known as e-devices.
• Discuss self-injection methods with your doctor to determine which are available with your medication and will be easiest for you to use.

Biologic medications for spondylitis can’t be taken orally (by mouth), because they consist of large molecules that your body can’t properly absorb through your digestive tract. For proper absorption, biologics currently available for treating spondylitis must be taken by subcutaneous injection (injection under the skin) or by IV infusion directly into the bloodstream. Some biologic drugs for treating spondylitis are available for self-injection at home; others must be administered in a clinic or doctor’s office.

Biologics have enhanced the treatment of chronic inflammatory conditions such as ankylosing spondylitis, axial spondyloarthritis, rheumatoid arthritis, and psoriatic arthritis, among many other autoimmune diseases. These disease-modifying antirheumatic drugs (DMARDs) can significantly reduce symptoms, slow the progress of the disease, and improve quality of life for some people. Biologic drugs target proteins in the immune system that promote inflammation in people with spondylitis and damage healthy tissue.

The following anti-tumor necrosis factor (TNF) and interleukin-17 (IL-17) inhibitors are biologic drugs approved by the U.S. Food and Drug Administration (FDA) for treating spondylitis, and they can be administered by self-injection:

• Cimzia (a formulation of certolizumab pegol)
• Cosentyx (secukinumab)
• Enbrel (etanercept)
• Humira (adalimumab)
• Remicade (infliximab)
• Simponi (golimumab)
• Taltz (ixekizumab)

Three main types of self-injection include prefilled syringes, self-injection pens, and e-devices, all of which automatically deliver the proper dose. Talk to your rheumatologist about which type of self-injection might be appropriate for you. Depending on your particular condition and preferences, one method of self-injection may have advantages over others.

1. Prefilled Syringes

A prefilled syringe consists of a syringe and needle and includes the correct dose of a drug. The syringe is administered manually the way many shots or vaccines are typically taken. Prefilled syringes allow you to control the speed of the injection.

However, for people whose spondylitis affects their fingers and inhibits their coordination and dexterity, self-injecting with a prefilled syringe may be difficult.

2. Self-Injection Pens

A self-injection pen is a type of auto-injector prefilled with the appropriate dose of a drug. A self-injection pen has a mechanical spring-loaded needle hidden inside. People who are leery of needles — a common feeling — prefer this method because the needle remains hidden from view. When you hold the device against your skin, you can release it with the press of a button.

For some people, self-injection pens are easier to use than manual prefilled syringes, but they can also cause more swelling, bruising, or pain at the injection site.

One MySpondylitisTeam member reassured another member about auto-injectors. “You cannot see the needle when you give yourself the shot,” they wrote.

Another member, who has been taking a biologic for three years, concurred: “It’s available in an injectable pen and you never see the needle. It can sting, but not that bad.”

3. E-Devices

E-devices are electronic auto-injectors that are reusable and have a range of functions. They come in different models and can include features such as:

• The ability to control the speed of injection
• Logging capabilities to record treatments with the device
• Sensors that prevent injection if the device does not have proper contact with the skin

E-devices may seem complicated for those who prefer a simpler form of self-injection.

Self-Injection Side Effects

Side effects can occur at the injection site, including pain, itching, discoloration, or swelling. Read more about tips for easier self-injection.

Talk to your health care team for medical advice about any reactions you have at the site of injection. There may be ways to minimize them.

Other common side effects from biologic drugs can include headaches, nausea, or flushing. They can also increase your risk of infection. When considering a new treatment option, be sure to discuss potential side effects with your rheumatologist.

If you experience symptoms such as shortness of breath, itchy eyes, a full-body rash, fever, or chills, you may be experiencing an allergic reaction to a self-injection and should seek emergency medical assistance immediately.

Talk With Others Who Understand

On MySpondylitisTeam, the social network for people with spondylitis and their loved ones, more than 87,000 members come together to ask questions, give advice, and share their stories with those who understand life with spondylitis.

Have you used one or more types of self-injection? Did you find it easy to use? Add your thoughts in the comments below, or start a conversation with others on your Activities page.