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Carmel Stober

and Hill Gaston

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date: 23 April 2021

This collection of papers may differ from those chosen in other forms of arthritis in having a paucity of papers on treatment and, in particular, no classic double-blind placebo-controlled clinical trials. The single trial included, by Brandt et al., was a small (tiny) open-label trial but nevertheless established beyond reasonable doubt the major role of tumour necrosis factor inhibition in the treatment of ankylosing spondylitis—later confirmed in formal trials and extended to other forms of spondyloarthritis (SpA). Arguably, this has been the only significant advance in treatment of SpA in the last three to four decades (discounting the necessary testing of various novel non-steroidal anti-inflammatory drugs over the years). Many other biologics and small molecules are of course being investigated currently for SpA treatment. However, while this is an exciting time in SpA treatment research, it has not yet generated any “classic” papers.

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