A major subset of patients with ankylosing spondylitis followed up in tertiary clinical care require anti-tumour necrosis factor α biological treatments according to the current guidelines

Therapeutic options for severe ankylosing spondylitis (AS) have been limited to non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and to some traditional disease modifying drugs (DMARDs) such as sulfasalazine and methotrexate. In view of open label and controlled trials of treatment with a monoclonal chimeric tumour necrosis factor (TNF) α antibody (infliximab), and with recombinant human TNF receptor (etanercept), the need for more effective second line treatments in AS seems to be met.1–4 In this study we aimed at determining the proportion of patients with active AS, despite treatment with NSAIDs and second line treatments (sulfasalazine, methotrexate), using current guidelines for anti-TNF treatment in a tertiary clinical care. Study patients were selected according to the Modified New York criteria. ASAS and SPARTAN guidelines for biological treatments of AS were …

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