TeleSpA is the first trial to test both the effectiveness and cost-effectiveness of patient-initiated follow-up supported by asynchronous telemonitoring (PIFU/TM) in patients across the whole spectrum of SpA with a stable disease state. The primary endpoint, a reduction of ≥25% in the annual number of rheumatology visits with PIFU/TM compared to usual care, was met (mean between-group difference 25·4%). TeleSpA further demonstrated that this approach for follow-up of patients was not at the expense of health outcomes or experience with care, and saved healthcare costs.