TNF and inflammatory bowel disease: All biologic therapies currently approved for the treatment of axSpA are included in the recent recommendations approved in 2019 by the American College of Rheumatology, Spondylitis Association of America and Spondyloarthritis Research and Treatment Network (17), which strongly recommend to treat adult patients with active AS despite TNFα inhibitor (primary non-responder) with secukinumab or ixekizumab, while IL17 inhibitors are not recommended in the presence of inflammatory bowel disease (IBD) or recurrent uveitis.