It has been shown that baseline syndesmophytes [4, 5], inflammatory activity as assessed by C-reactive protein (CRP), by the Ankylosing Spondylitis Disease Activity Score (ASDAS), or by the presence of inflammatory changes on magnetic resonance imaging (MRI) [6–12], and cigarette smoking [13] are factors associated with more rapid radiographic spinal progression. This evidence concerns the gene CRP and spondylitis.