Its a balancing act for sure, joint damage or organ damage. Which is the least tolerable? We can live, albeit unpleasant, with joint damage. We cannot live without kidneys or liver though. Choise your poison wisely.

@A MySpondylitisTeam Member. I talk to plenty of retired medical professionals all the time. One was just last night while here at a Sandals resort in St Vincent. He's a retired Radiologist who did Radiology readings for 50 years. These retired professionals all agree with my opinion about biologics in general... they are simply the replacement drug drs prescribe patients who demand a drug to heal them so they dont need to do the hard work of nutrition and exercise regularly. The last generation of medical professionals over prescribed opiates, the generation before relied too heavily on antibiotics. Drs lose patients when they dont give a hoped for cure through easy medication. Patients dont like being told that they need to diet and exercise more.
I found the use if the PainScale App very helpful for logging diet, supplements, meds, exercise, activities, and pain. Good luck Sonja. Feel free to bounce ideas off ne anytime. 😌🙏

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A MySpond...

@A MySpondylitisTeam Member. I notice an increase in inflammation that can come on within an hour or so or take a couple of days any time i drink as little as an ounce of wine, eat a small candy bar or cookie, or any amount of ultra processed foods. I have been exercising regularly for 45 years and akways considered myself a healthier than average person. But this disease doesn't allow for any indulgences at all ever for any reason. That means your "fairly" inflammation friendly diet may need to be bumped up to a "highly 100% of the time" diet. In addition to that, i find supplements that are strong antioxidants helpful if im not getting them in my daily diet. My most notably helpfuls are andrographis, boswellia, curcuminoids, fucoxanthin, and astaxanthin, quercetin, theaflavin, fisetin, vitexin. If you're interested in learning what those do, you can look them up at National Institute of Health.gov or scroll through to my posts about them beginning about this time last year.
I also have always exercised regularly, average 5 days a week, for 45 years. I had to shift my exercise routine focus from one that enhances strength and endurance to one that emphasizes flexibility, stabilization of support muscles, joint mobility and balance. Zero impact.
My diet had to be improved to pretty close to perfect without cheat days even on special occasions, my exercise had to change to a rehab and recovery focus, my lifestyle had to slow to a near crawl pace. My pain can be intense, but is much less frequent. Average pain scale went from daily average 7\8 to 2/3. Fatigue level dropped by as much too.

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You can control the inflammation naturally with only occasional use of Nsaids for flares.

Keep in mind, AS can affect the eyes, lungs, heart and intestines. And it’s a progressive life long disease that is unique to the individual. Taking any medication is a balancing = (it my be) quality versus quantity of life. No one but you can make that decision for yourself.