We read the recently published guidelines from the Asia-Pacific League of Associations for Rheumatology (APLAR) for the management of axial spondyloarthritis (AxSpA) with great expectation. 1 The Asia-Pacific region is home to nearly 2/3 of the world's population, and many countries of this region have cost-constrained healthcare settings, with significant out-of-pocket health expenditure. The burden of infectious diseases, including tuberculosis, is another overarching concern in this region. The authors of this letter practice in a similarly constrained healthcare setting; therefore, we would like to express our concerns regarding the aforementioned guidelines.First, we felt the literature search in forming the APLAR AxSpA guidelines 1 to be inadequate. In our opinion, the authors should have also searched Scopus and the Web of Science, since these databases have greater breadth of coverage than Pubmed (Medline) or Embase, including non-anglophonic publications. 2 Furthermore, a handsearching of conference abstracts, to identify unpublished abstracts, should also have been conducted, supplemented with a search of clinical trials databases to identify ongoing or unpublished studies. We feel that this is particularly relevant in Asian settings, since concerns about English language may delay or even prevent publication of valuable scientific information from these areas. Furthermore, while the authors have used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to evaluate the quality of evidence presented, we could not find anywhere in the manuscript 1 detailed summary-of-findings tables generated using GRADE, which would have enhanced the understanding of these recommendations for the reader.We found a paucity of Asia-Pacific literature that was analyzed while formulating the guideline. We agree that there may not be many randomized controlled trials on this subject from these areas.