How should I approach the management of a patient with peripheral spondyloarthritis who is not responding to NSAIDs?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For patients with peripheral spondyloarthritis who do not respond to NSAIDs, consider offering local corticosteroid injections as monotherapy for non-progressive monoarthritis .

Offer standard disease-modifying anti-rheumatic drugs (DMARDs) to people with peripheral polyarthritis, oligoarthritis, or persistent or progressive monoarthritis associated with peripheral spondyloarthritis .

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