Macfarlane GJ, et al. - Investigation of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a former model using data from 1,810 persons with axSpA enrolled during 2012–2017 was done in order to ascertain modifiable factors related to poor quality of life (QoL) in individuals with axial spondyloarthritis (axSpA). Four out of five factors involved in a former model of poor QoL in persons with axSpA were validated, ie, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, however, the performance of the model was enhanced via adding measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, depression, sleep disturbance, activity impairment, fibromyalgia (Symptom Severity Scale and Widespread Pain Index) and tobacco smoking were the six factors that prognosticated Ankylosing Spondylitis Quality of Life. Therefore, this study validates that in individuals with axSpA, poor QoL, along with high disease activity and poor function, is independently affected by sleep disturbance, mood, and widespread pain. However, for treatment in the current European League Against Rheumatism guidelines for managing the condition, these supplementary factors are not acknowledged as targets.