Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J