Nikiphorou E, Ramiro S, Sepriano A, et al. - The present study was conducted to assess the association between smoking and imaging outcomes over 5 years in axial spondyloarthritis (SpA) and to evaluate if socioeconomic factors influence these correlations. Researchers included Axial SpA patients from the Devenir des Spondylarthropathies Indifferérenciées Récentes cohort. This study included 406 axial SpA patients (52% male, 40% smokers, and 18% blue collar). The data revealed a strong relationship between smoking at baseline and MRI‐detected SI joint inflammation at each visit over a time period of 5 years in axial SpA patients with a blue‐collar job or low education level. These data imply a possible role for mechanical stress amplifying the impact of smoking on axial inflammation in axial SpA.