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Understanding the causes of treatment failure is crucial for the management of axial spondyloarthritis

Nature Reviews Rheumatology volume 21, pages 309–311 (2025)Cite this article

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Although numerous therapies are available for axial spondyloarthritis, more than half of patients do not achieve remission or respond to treatment. Understanding the reasons for non-response in axial spondyloarthritis is essential for effective management of this disease.

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Fig. 1: Typical patterns of MRI changes in the sacroiliac joints in axial spondyloarthritis and osteitis condensans ilii.

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Authors and Affiliations

  1. Division of Rheumatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Denis Poddubnyy

  2. Division of Rheumatology, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada

    Denis Poddubnyy

  3. Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Berlin, Germany

    Denis Poddubnyy

  4. Rheumazentrum Ruhrgebiet, Herne and Ruhr-University, Bochum, Germany

    Xenofon Baraliakos

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  1. Denis Poddubnyy
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  2. Xenofon Baraliakos
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Correspondence to Denis Poddubnyy.

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Competing interests

D.P. has received research support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer and UCB; consulting fees from AbbVie, Eli Lilly, Greywolf Therapeutics, Janssen, Merk, Moonlake, Novartis, Pfizer and UCB; and speaker fees from AbbVie, Canon, Eli Lilly, Janssen, Medscape, Novartis, Peervoice, Pfizer and UCB. D.P. is a member of the executive committee of ASAS. X.B. has received research support from Abbvie, Celltrion, Janssen, Moonlake and Novartis; and consulting fees from Abbvie, Advanz, Alexion, Alphasigma, Amgen, BMS, Cesas, Celltrion, Clarivate, Galapagos, J&J, Lilly, Moonlake, Novartis, Peervoice, Pfizer, Roche, Sandoz, Springer, Stada, Takeda, UCB and Zuellig. X.B. is past president of ASAS and president-elect of EULAR.

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The ASAS Case Library: https://cases.asas-group.org/

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Poddubnyy, D., Baraliakos, X. Understanding the causes of treatment failure is crucial for the management of axial spondyloarthritis. Nat Rev Rheumatol 21, 309–311 (2025). https://doi.org/10.1038/s41584-025-01254-5

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