In AS (n=91,493), D2T defined as ≥2 b/tsDMARD classes plus elevated CRP. Risk factors: HLA-B27+ (OR 1.30), obesity (OR 1.20), depression (OR 1.22). D2T group had higher CRP (55.7 mg/L), BMI (31.1), and more EAMs (IBD, psoriasis, uveitis). Female predominance (56.9%)Abstract https://t.co/EHCt5wq4ot