However, other studies have shown that biomarker concentrations are influenced by anti-TNF use, longitudinally in PsA [34, 35], cross-sectionally [32, 36] and longitudinally [11, 17, 37–40] in AS, in AS clinical responders and non-responders [38], only in AS patients with peripheral arthritis [41], and with differential direction of change (Dkk-1) in AS compared with RA [15]. This evidence concerns the gene DKK1 and rheumatoid arthritis.