Sari I, et al. - Researchers explored progression rates, as well as factors predictive of spinal progression in a longitudinal observational cohort of ankylosing spondylitis (AS) patients. They also determined the influence of tumor necrosis factor inhibitor (TNFi) therapy on radiographic progression. Participants included AS patients who had baseline and follow-up cervical and lumbar X-rays. The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) was used to evaluate radiographic damage. Between the 0 to 2, 2 to 4 and 4 to 6 years, the alteration in mSASSS scores was 1.23 (2.68), 1.47 (2.86), and 1.52 (3.7) units respectively. In 2 years’ time, progression was noted in overall 24.3% of the group. The factors that conferred a high-risk group for disease progression included male gender, presence of baseline damage, active disease state and higher inflammatory markers. By decreasing the rate of radiographic progression, a disease-modifying influence was shown by treatment with TNFi.