Beek KJ, et al. - In patients with ankylosing spondylitis (AS), researchers assessed the long term effects of TNF-inhibitors (TNFi) on bone mineral density (BMD) and the incidence of vertebral fractures (VFx). For this investigation, they involved consecutive patients with active AS with TNFi treatment duration up to 4 years with available DXA scans and spine X-rays. A total of 135 AS patients were included. Despite improving BMD and a well-known decrease in disease activity, investigators still found new VFx, an increase in the number and grade of VFx and radiographic progression during 4 years of TNFi treatment in long-term AS patients.