Management of D2M axSpA should shift from a 'next biologic' to a 'right mechanism' paradigm, with mechanistic stratification informing treatment allocation. Patients with TR-axSpA warrant pharmacological escalation or novel therapeutic approaches; conversely, the majority of D2M patients require multidisciplinary care prioritizing evidence-based non-pharmacological interventions, which are substantially underutilized despite robust efficacy data. This must be underpinned by further research targeting D2M axSpA cohorts.
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Jack Shi Jie Yuan
Lucia Yin
Syed Haider Tahir
Expert Opinion on Pharmacotherapy
University College London
King's College London
Royal Free London NHS Foundation Trust
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Yuan et al. (Wed,) studied this question.
www.synapsesocial.com/papers/69d896406c1944d70ce07950 — DOI: https://doi.org/10.1080/14656566.2026.2657996
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