Abstract
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease with variable clinical presentation and often delayed diagnosis. The Assessment of Spondyloarthritis International Society (ASAS) recently proposed a consensus definition of early axSpA to standardize research and improve comparability across studies. This review outlines the rationale and methodology of the ASAS-SPEAR (SPondyloarthritis EARly) initiative and discusses its implications for clinical research. Despite its promise, recent studies applying the definition have shown that treatment outcomes in early axSpA, defined as ≤2 years of symptom duration, do not consistently differ from established disease. Methodological limitations and heterogeneous criteria in earlier literature underscore the need for refined, evidence-based definitions. Future prospective trials using the ASAS criteria and stratified by symptom duration and clinical features are needed to clarify the value of early intervention and its potential impact on disease progression. The ASAS definition offers a valuable research framework, though its application in clinical practice awaits further validation.