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Early treatment changes the outcome of rheumatoid arthritis treatment, in that response rates are higher with earlier disease-modifying anti-rheumatic drug treatment and damage is substantially reduced. Axial spondyloarthritis is an inflammatory axial disease encompassing both nonradiographic axial spondyloarthritis and established ankylosing spondylitis. In axial spondyloarthritis, studies of magnetic resonance imaging as well as tumor necrosis factor inhibitor treatment and withdrawal studies all suggest that early effective suppression of inflammation has the potential to reduce radiographic damage. This potential would suggest that the concept of a window of opportunity is relevant not only to rheumatoid arthritis but also to axial spondyloarthritis. The challenge now remains to identify high-risk patients early and to commence treatment without delay. Developments in risk stratification include new classification criteria, identification of clinical risk factors, biomarkers, genetic associations, potential antibody associations and an ankylosing spondylitis-specific microbiome signature. Further research needs to focus on the evidence for early intervention and the early identification of high-risk individuals.<\/jats:p>","DOI":"10.1186\/ar4561","type":"journal-article","created":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T15:16:02Z","timestamp":1399907762000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["The window of opportunity: a relevant concept for axial spondyloarthritis"],"prefix":"10.1186","volume":"16","author":[{"given":"Philip C","family":"Robinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2014,5,12]]},"reference":[{"key":"4180_CR1","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1136\/annrheumdis-2012-202698","volume":"73","author":"X Baraliakos","year":"2013","unstructured":"Baraliakos X, Haibel H, Listing J, Sieper J, Braun J: Continuous long-term anti-TNF therapy does not lead to an increase in the rate of new bone formation over 8\u00a0years in patients with ankylosing spondylitis. 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