Aug 11, 2026 · 45 min · 9 segments
The new clinical guidelines for juvenile and adult axial spondyloarthritis (axSpA), developed collaboratively by the American College of Rheumatology (ACR), the Spondylitis Association of America…
John HausmannHost
Liron CaplanGuest
Matthew StollGuest
[upbeat music] Welcome back to another episode of ACR On Air, the official podcast of the American College of Rheumatology.
The new clinical guidelines for juvenile and adult axial spondyloarthritis are intended to help clinicians navigate the difficult, often uncertain decisions that arise in everyday practice.
The patient in front of us may have inflammatory back pain, but an equivocal MRI.
They may also have psoriasis, uveitis, or inflammatory bowel disease that changes which treatment may make the most sense for that particular patient.
The patient may have failed several therapies, or they may be a teenager whose most important goal is not a disease activity score, but simply to being able to keep playing football.
The guidelines also give us a rare opportunity to compare how we approach the same disease across the lifespan.
For the first time, juvenile axial spondyloarthritis has its own dedicated guideline, and in adults, radiographic and non-radiographic axial spondyloarthritis are now approached as part of a unified disease spectrum.
To discuss what changed, why it changed, and what these recommendations mean for our patients, I'm joined by two of the primary authors.
Dr. Liron Kaplan led the adult axial spondyloarthritis guideline, and Dr. Matthew Stoll, who led the pediatric guideline.
Why methotrexate generally has little role to play in axial disease, and how to think about physical activity, contact sports, manual labor, tapering, dose escalation, and even dual targeted therapy.
We also explore why these guidelines do not endorse a rigid treat to target strategy and how the guideline writers make recommendations when there's little evidence that doesn't provide a clear answer.
Dr. Matthew Stoll is a pediatric rheumatologist at the University of Alabama at Birmingham.
His research focuses on pediatric spondyloarthritis, including its relationship with inflammatory bowel disease and the intestinal microbiome.
Dr. Liron Kaplan is an associate professor of medicine at the University of Colorado School of Medicine and a rheumatologist and health services researcher specializing in spondyloarthritis.
His research examines how treatment selection, adherence, and healthcare delivery affect patient outcomes.
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[upbeat music] Welcome back to another episode of ACR On Air, the official podcast of the American College of Rheumatology.
The new clinical guidelines for juvenile and adult axial spondyloarthritis are intended to help clinicians navigate the difficult, often uncertain decisions that arise in everyday practice.
The patient in front of us may have inflammatory back pain, but an equivocal MRI.
They may also have psoriasis, uveitis, or inflammatory bowel disease that changes which treatment may make the most sense for that particular patient.
The patient may have failed several therapies, or they may be a teenager whose most important goal is not a disease activity score, but simply to being able to keep playing football.
The guidelines also give us a rare opportunity to compare how we approach the same disease across the lifespan.
For the first time, juvenile axial spondyloarthritis has its own dedicated guideline, and in adults, radiographic and non-radiographic axial spondyloarthritis are now approached as part of a unified disease spectrum.
To discuss what changed, why it changed, and what these recommendations mean for our patients, I'm joined by two of the primary authors.
Dr. Liron Kaplan led the adult axial spondyloarthritis guideline, and Dr. Matthew Stoll, who led the pediatric guideline.
Why methotrexate generally has little role to play in axial disease, and how to think about physical activity, contact sports, manual labor, tapering, dose escalation, and even dual targeted therapy.
We also explore why these guidelines do not endorse a rigid treat to target strategy and how the guideline writers make recommendations when there's little evidence that doesn't provide a clear answer.
Dr. Matthew Stoll is a pediatric rheumatologist at the University of Alabama at Birmingham.
His research focuses on pediatric spondyloarthritis, including its relationship with inflammatory bowel disease and the intestinal microbiome.
Dr. Liron Kaplan is an associate professor of medicine at the University of Colorado School of Medicine and a rheumatologist and health services researcher specializing in spondyloarthritis.
His research examines how treatment selection, adherence, and healthcare delivery affect patient outcomes.
