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Editor’s note: The Assessment in SpondyloArthritis International Society (ASAS) first published a consensus statement on the use of anti-tumor necrosis factor (anti-TNF) agents in patients with axial spondyloarthritis in 2003. This report describes the second update of that consensus statement, on the basis of evidence published over the last few years. The update was based on review of the literature, a survey of 1242 rheumatologists in 18 countries, and national guidelines from 23 countries. This information was discussed at meetings of ASAS and any changes to the previous consensus statement were subject to majority voting. The main features of the final consensus statement were as follows: