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The objective, as presented at the SPARTAN 2024 Annual Meeting, is to delineate the evolving framework for identifying and addressing D2T-axSpA, with a focus on inflammatory and non-inflammatory mechanisms of treatment failure and the implications for clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>Studies have highlighted a prevalence of D2T-axSpA ranging from 19.5 to 28.3% in real-world cohorts, with associated risk factors including peripheral arthritis, comorbidities, and female gender. Recent advances include the Assessment of SpondyloArthritis International Society\u2019s (ASAS) preliminary definition of \u201cdifficult-to-manage axSpA\u201d (D2M-axSpA), which encompasses treatment-refractory cases and broader management challenges and `treatment refractory axSpA\u00b4 where objective evidence of ongoing inflammation is mandatory.\u00a0<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>D2T-axSpA presents significant challenges due to persistent disease activity and the interplay of inflammatory and non-inflammatory drivers. The emerging definitions and research into personalized treatment strategies promise to refine clinical management. Future directions emphasize biomarker-driven precision medicine, novel therapeutic combinations, and holistic care models to improve outcomes in this complex patient population.\u00a0<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11926-025-01183-y","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T04:41:01Z","timestamp":1738557661000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Unraveling the Challenges of Difficult-to-Treat Spondyloarthritis: SPARTAN 2024 Annual Meeting Proceedings"],"prefix":"10.1007","volume":"27","author":[{"given":"Andre L","family":"Ribeiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-033X","authenticated-orcid":false,"given":"Fabian","family":"Proft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"issue":"10089","key":"1183_CR1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/S0140-6736(16)31591-4","volume":"390","author":"J Sieper","year":"2017","unstructured":"Sieper J, Poddubnyy D. 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