Beek KJ, et al. - In patients with ankylosing spondylitis (AS), researchers assessed the long-term impacts of TNF inhibitors (TNFis) on BMD (classified according to the WHO criteria for osteoporosis) and the incidence of vertebral fractures (VFxs), classified as a Genant score >1/>20% height loss. Study participants included consecutive patients with active AS with TNFi treatment duration up to 4 years with available DXA scans and spine X-rays. Overall, there were 135 patients with AS. Despite improved BMD and decreased disease activity, the authors still found new VFxs, increased severity in the number and grade of VFxs, and radiographic progression during 4 years of TNFis treatment in AS patients with long duration of disease.