Table 1.

When to start anti-TNF therapy.

Axial SpA	Persistently high disease activity (BASDAI > 4)
	Failure of at least two NSAIDs
Peripheral SpA	Failure of intra-articular steroid injection
	Failure of DMARDs
Poor prognostic factor risk	High CRP/ESR
	Bone edema at MRI
Psoriatic arthritis	Moderate or severe form in case of failure to respond to at least one DMARD
Enthesitis/dactylitis	In severe cases or after failure of traditional therapy

BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; CRP, C-reactive protein; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; MRI, magnetic resonance imaging; NSAID, nonsteroidal anti-inflammatory drug; SpA, spondyloarthritis; TNF, tumor necrosis factor.