Among the axSpA patients, those with headache were also predominantly female [n = 21 (75%) vs. n = 16 (42.11%), p = 0.005] and had a higher prevalence of concomitant fibromyalgia (56.25% vs. 21.05%, p = 0.003), higher frequency of HLA-B27 (39.47% vs. 15.62%, p = 0.025), and a higher rate of biological drug usage, in particular with the use of anti-TNF-alpha therapy (39.47% vs. 18.75%, p = 0.015). This evidence concerns the gene TNF and fibromyalgia.