Karmacharya P, Duarte-Garcia A, Dubreuil M, et al. - Via conducting comprehensive database search, researchers studied the impact of therapies on radiographic progression in axial spondyloarthritis (axSpA). For this systematic review and meta-analysis, 24 studies [18 with tumor necrosis factor inhibitors (TNFi), 8 with non-steroidal anti-inflammatory drugs (NSAIDs), and 1 with secukinumab] were involved. Although there was no significant protective effect of TNFi treatment on spinal radiographic progression of ankylosing spondylitis at 2 and ≥ 4 years, analysis restricted to studies with low bias risk showed a protective effect at ≥ 4 years. Long-term TNFi exposure, therefore, might have radiographic progression benefit. No difference with NSAIDs or secukinumab at 2 years was observed.