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Axial spondyloarthritis: time to stop the split 10 years on

The 2019 ACR–SAA–SPARTAN treatment recommendations for axial spondyloarthritis incorporate useful advice on new therapies, treatment strategy and the use of imaging. But is it appropriate to still recommend different treatment strategies for non-radiographic and radiographic disease when available evidence suggests they are part of the same clinical spectrum?

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The work of X.M. is supported by the Catalan Society of Rheumatology. The work of H.M.-O. is supported by the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR or the UK Department of Health.

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Correspondence to Helena Marzo-Ortega.

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X.M. declares that he has received speaking fees from Novartis, Sanofi and UCB. H.M.-O. declares that she has received research grants, honoraria and/or speaking fees from AbbVie, Celgene, Eli-Lilly, Janssen, Novartis, Pfizer and UCB and that she is a co-author of the 2016 ASAS–EULAR management recommendations for axial spondyloarthritis and a medical advisor to the Spondylitis Association of America.

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Michelena, X., Marzo-Ortega, H. Axial spondyloarthritis: time to stop the split 10 years on. Nat Rev Rheumatol 16, 5–6 (2020).

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