There has been an explosion of therapies available in Australia for the treatment of psoriatic arthritis, seronegative spondyloarthropathies and associated extra-articular diseases. Our knowledge of how to use biologic and targeted synthetic DMARDs is supported by recent studies that differentiate the use of medications on the basis of disease manifestations including axial disease, skin disease and inflammatory bowel disease. While emerging therapies offer the hope of a more personalised approach to patient care, disease classification in axial spondyloarthropathies informing medication choice remains controversial and choosing medications on the basis of enthesitis and dactylitis is challenging. Understanding patient preferences in management of spondyloarthropathies may help clinicians to personalise biologic choices in a patient centred manner.