Deodhar A, et al. - Researchers sought to determine how certolizumab pegol (CZP), an anti–tumor necrosis factor treatment, affects patients with nonradiographic axial spondyloarthritis (SpA) with objective signs of inflammation. From 80 centers in Australia, Europe, North America, and Taiwan, 317 adults with active disease were randomized to receive placebo plus nonbiologic background medication (NBBM) (n = 158) or CZP plus NBBM (n = 159) in this ongoing parallel-group double-blind study. Outcomes support the superiority of adding CZP vs placebo to background medication in patients with active nonradiographic axial SpA. Results indicate the infrequent occurrence of remission in nonradiographic axial SpA treated without biologics, demonstrating the necessity for treatment beyond nonbiologic therapy.