Axial Spondyloarthritis (axSpA) Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, Segmented By Type (Ankylosing spondylitis (AS) and Non- radiographic axial spondyloarthritis (nr-axSpA)), By Drug Class (Non-steroidal anti-inflammatory drugs (NSAID), Glucocorticoids, Anti-rheumatic drugs, Others), By Region and Competition, 2021-2031F

Forecast Period	2027-2031
Market Size (2025)	USD 6.08 Billion
CAGR (2026-2031)	5.32%
Fastest Growing Segment	Non-steroidal anti-inflammatory drugs (NSAID)
Largest Market	North America
Market Size (2031)	USD 8.31 Billion

Market Overview

The Global Axial Spondyloarthritis (axSpA) Market will grow from USD 6.08 Billion in 2025 to USD 8.31 Billion by 2031 at a 5.32% CAGR. Axial Spondyloarthritis represents a spectrum of chronic inflammatory rheumatic diseases specifically affecting the spine and sacroiliac joints which encompasses both ankylosing spondylitis and nonradiographic variants. The expansion of this global market is primarily driven by the rising prevalence of autoimmune disorders combined with the increasing clinical adoption of advanced biologic therapeutics including interleukin inhibitors. Furthermore the regulatory approval of cost effective biosimilars and enhanced screening initiatives are improving patient access to essential treatments and fundamentally supporting the sector trajectory.

Despite these advancements a significant challenge limiting market scope is the substantial latency in clinical identification which prevents timely therapeutic intervention. This diagnostic inefficiency restricts the addressable patient population and complicates long term disease management. According to the Axial Spondyloarthritis International Federation, in 2024, patients globally experienced an average delay of 7.4 years between symptom onset and receiving a formal diagnosis. Such delays remain a critical barrier to optimal patient outcomes and hinder fuller market penetration.

Key Market Drivers

The commercialization of novel IL-17 and JAK inhibitor therapeutics is fundamentally altering the treatment paradigm for axial spondyloarthritis by offering targeted efficacy for patients resistant to traditional TNF inhibitors. These advanced pharmacotherapies are rapidly capturing market share due to their ability to address both radiographic and non-radiographic disease variants, significantly widening the treatable patient pool. The adoption of these agents is further accelerated by their proven capability to reduce inflammation and prevent structural damage in the spine. According to Novartis, October 2024, in the 'Q3 2024 Financial Results', global sales for the IL-17 inhibitor Cosentyx surged to USD 1.7 billion for the quarter, underscoring the substantial commercial demand for these targeted biologics. Additionally, the market is witnessing a shift towards oral JAK inhibitors, which offer a convenient route of administration compared to injectable biologics. According to AbbVie, October 2024, in the 'Third-Quarter 2024 Financial Results', global net revenues for the JAK inhibitor Rinvoq reached USD 1.61 billion, reflecting the high value payers and providers place on these innovative mechanisms within the immunology sector.

A robust clinical pipeline of next-generation biologics is further propelling market expansion, characterized by the development of dual-cytokine inhibitors and nanobodies designed to achieve deeper remission rates. This continuous influx of novel candidates fosters a competitive environment that enhances treatment accessibility and stimulates sector growth through the introduction of differentiated mechanisms of action. For instance, the recent emergence of dual IL-17A and IL-17F inhibitors has shown promise in clinical settings for delivering superior skin and joint clearance compared to earlier standards of care. According to UCB, July 2024, in the 'Half-Year Report 2024', net sales for the recently launched biologic Bimzelx reached EUR 215 million for the first six months of the year, demonstrating the rapid market uptake of next-generation assets. This pipeline vitality ensures a sustained trajectory of innovation, directly addressing the unmet needs of the global patient population and reinforcing long-term market resilience.

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Key Market Challenges

The substantial latency in clinical identification serves as a primary bottleneck restricting the commercial expansion of the global axSpA market. This diagnostic inefficiency effectively strands a large portion of the eligible patient population in primary care or non-rheumatological settings where advanced biologic therapies are neither prescribed nor reimbursed. Consequently, pharmaceutical manufacturers face a significantly reduced addressable market, as patients remain untreated or mismanaged with non-specific interventions for extended periods. The revenue potential of high-value therapeutics is directly curtailed because these individuals enter the specialized rheumatology channel far later than optimal, often missing the window for early intervention strategies.

This fragmented referral pathway significantly hampers market penetration rates by creating a disconnect between high disease prevalence and actual therapeutic adoption. According to the Spondylitis Association of America, in 2024, one in four patients visited five or more healthcare professionals in search of a diagnosis. Such convoluted clinical journeys dilute the efficiency of screening initiatives and delay the initiation of biologic treatments. Until this referral gap is bridged, the market will struggle to capitalize on the true prevalence of the disease, leaving significant commercial value unrealized.

Key Market Trends

The integration of AI-enhanced MRI for early disease detection is emerging as a critical trend in the Global Axial Spondyloarthritis (axSpA) Market. Algorithms now analyze scans to automate the identification of inflammatory markers often missed during standard reviews, countering diagnostic latency. According to UCB Pharma, October 2024, in the 'Performance analysis of a deep-learning algorithm' study, a novel AI model for detecting sacroiliac joint inflammation demonstrated 74% absolute agreement with expert readers. These innovations are pivotal for providing standardized tools to distinguish axSpA from mechanical back pain and accelerating therapeutic intervention.

The rising market penetration of biosimilar TNF inhibitors is restructuring competitive dynamics. Healthcare systems are incentivizing these cost-efficient alternatives to legacy biologics, effectively expanding treatment accessibility. This shift is evident in the erosion of market exclusivity for adalimumab, where formulary changes are driving volume transitions away from reference products. According to Samsung Bioepis, October 2024, in the 'Fourth Quarter 2024 US Biosimilar Market Report', the market share for adalimumab biosimilars in the United States expanded from 2% in early 2024 to 22% by August 2024. This trend forces originator manufacturers to compete on price while opening fiscal space for newer mechanisms.

Segmental Insights

The Non-steroidal anti-inflammatory drugs segment is recognized as the fastest growing component of the Global Axial Spondyloarthritis Market, driven by its mandated position as the primary therapeutic intervention. Clinical guidelines established by the American College of Rheumatology and the Assessment of SpondyloArthritis international Society universally recommend these agents as the initial treatment for active disease, ensuring immediate adoption upon diagnosis. Consequently, increasing global patient identification and the essential requirement for baseline symptom management prior to advanced biologic prescription are fueling the accelerated expansion of this foundational market segment.

Regional Insights

North America holds the leading position in the global axial spondyloarthritis market, driven by a robust healthcare infrastructure and high diagnosis rates. The dominance of this region is largely attributed to favorable reimbursement policies and the availability of advanced treatment options, including biologics and JAK inhibitors. Additionally, supportive regulatory initiatives by the U.S. Food and Drug Administration accelerate the approval and commercialization of new therapies, ensuring patient access to effective management. The concentrated presence of major pharmaceutical companies conducting research in the United States further strengthens the regional market by fostering continuous therapeutic development.

Recent Developments

• In January 2025, MoonLake Immunotherapeutics announced the initiation of the Phase 2 S-OLARIS clinical trial to evaluate its investigational nanobody, sonelokimab, in patients with active axial spondyloarthritis. This open-label proof-of-concept study was designed to assess the efficacy of the therapy in reducing inflammation in the spine and sacroiliac joints using advanced imaging techniques, specifically positron emission tomography combined with magnetic resonance imaging. The commencement of this trial marked a strategic expansion of the company's clinical pipeline into rheumatology, investigating the potential of inhibiting IL-17A and IL-17F dimers to treat this debilitating inflammatory disease.
• In November 2024, UCB presented long-term data at the ACR Convergence annual meeting, highlighting the sustained efficacy of its dual IL-17A and IL-17F inhibitor in treating axial spondyloarthritis. The results, derived from the two-year follow-up of the Phase 3 BE MOBILE 1 and BE MOBILE 2 studies, showed that a high proportion of patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis maintained clinical responses over the extended period. These findings reinforced the durability of the therapy in reducing disease activity and improving physical function, supporting its use as a long-term management option for these chronic conditions.
• In September 2024, UCB received approval from the U.S. Food and Drug Administration for its novel biologic therapy to treat adults with active non-radiographic axial spondyloarthritis and active ankylosing spondylitis. This regulatory decision established the drug as the first and only treatment approved in the United States for these indications that selectively inhibits both IL-17A and IL-17F, two key cytokines driving the inflammatory process. The approval was supported by data from the Phase 3 BE MOBILE 1 and BE MOBILE 2 clinical trials, which demonstrated statistically significant improvements in disease signs and symptoms compared to placebo.
• In April 2024, Eli Lilly and Company released new insights from a post-hoc analysis of the Phase 3 COAST-V clinical trial, which evaluated its IL-17A inhibitor in patients with ankylosing spondylitis. The research focused on the relationship between inflammation control and symptom relief, revealing that the therapy significantly reduced spinal pain at night compared to placebo after 16 weeks. Notably, this reduction in pain was observed in patients regardless of whether they achieved complete resolution of inflammation as measured by MRI or C-reactive protein levels, suggesting that the treatment may offer pain relief mechanisms distinct from its anti-inflammatory effects.

Key Market Players

• UCB S.A.
• Pfizer Inc.
• Abbott Laboratories Inc.
• Johnson & Johnson
• Merck & Co., Inc.
• AbbVie Inc.
• Novartis AG
• Eli Lilly and Company
• Amgen Inc.
• GlaxoSmithKline plc
• NorthStar Rx LLC

By Type	By Drug Class	By Region
Ankylosing spondylitis (AS) and Non- radiographic axial spondyloarthritis (nr-axSpA)	Non-steroidal anti-inflammatory drugs (NSAID) Glucocorticoids Anti-rheumatic drugs Others	North America Europe Asia Pacific South America Middle East & Africa

Report Scope:

In this report, the Global Axial Spondyloarthritis (axSpA) Market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

• Axial Spondyloarthritis (axSpA) Market, By Type:

• Ankylosing spondylitis (AS) and Non- radiographic axial spondyloarthritis (nr-axSpA)

• Axial Spondyloarthritis (axSpA) Market, By Drug Class:

• Non-steroidal anti-inflammatory drugs (NSAID)
• Glucocorticoids
• Anti-rheumatic drugs
• Others

• Axial Spondyloarthritis (axSpA) Market, By Region:

• North America
• United States
• Canada
• Mexico
• Europe
• France
• United Kingdom
• Italy
• Germany
• Spain
• Asia Pacific
• China
• India
• Japan
• Australia
• South Korea
• South America
• Brazil
• Argentina
• Colombia
• Middle East & Africa
• South Africa
• Saudi Arabia
• UAE