What factors lead you to recommend a JAK inhibitor as second-line therapy in a patient with radiographic axSpA who has had a primary non-response to a TNF inhibitor, before trying an IL-17 inhibitor?

This is an excellent question which requires not just a treatment plan but also a revelation of how we should be making patient management decisions in Spondyloarthritis (SpA). My initial reaction is that primary non-response to a TNFi is not the usual story; if this truly happens, I recommend re-ev...

For the patient with radiographic axSpA who has not responded to TNF inhibition, we have many choices available. I suspect most rheumatologists would select an anti-interleukin such as an anti-IL-17 therapy as their next choice. This would be based on favorable clinical data and relative ease of adm...