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At baseline, multivariate analysis showed that body mass index (BMI), erythrocyte sedimentation rate (ESR), and spinal structural damage were associated with lumbar spine Z-scores. Increases in BMD in the lumbar spine were correlated with reductions in ESR (r = 0.40, P = 0.02) and C-reactive protein (CRP) (r = 0.40, P = 0.02). Increases in BMD in the total hip were correlated with reductions in CRP (r = 0.38, P = 0.03). In adolescent axSpA patients, bone health was associated with systemic inflammation and the severity of structural da