van der Heijde D, et al. - This trial was designed with the intention of illustrating 4-year imaging outcomes of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA), treated with certolizumab pegol (CZP). The maintenance of a rapid decrease was reported in spinal and sacroiliac joints (SIJ) magnetic resonance imaging (MRI) inflammation up to week 204 among patients with CZP-treated axial spondyloarthritis (axSpA). A low, 4-year spinal progression was disclosed in this report, exhibiting less progression during years 2-4 than 0-2. Limited progression was illustrated via radiographic SIJ grading changes.