The treatment recommendation for ERA varies based on disease severity, including non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs, e.g. methotrexate and sulfasalazine), corticosteroids (intra-articular injection as adjunctive therapy and oral prednisolone as bridging therapy in moderate and high disease activity), and biologics e.g. antitumor necrosis factor (anti-TNF) for severe and refractory patients having multiple active arthritis, enthesitis and sacroiliitis that do not respond to other treatment modalities [13]. Here, TNF is linked to Sacroiliac arthritis.