The first choice to treat axial SpA in active IBD is anti-TNF agents.8,12,24,26 In case of non-response, the dose can be increased, the intervalshortened or the anti-TNF agent can be switched to another.24 In case axial SpA is in remission, continuing with adalimumab isadvised, as the risk of recurrence after treatment cessation seems high.However, ongoing research is conflicting, and the evidence is inconclusiveat the moment.24,40. This evidence concerns the gene TNF and inflammatory bowel disease.