There was no important clinical meaningful benefit .
Adverse effectsWe found very low- quality evidence of the effect of exercise versus either no intervention , or usual care .
We found moderate- to low- quality evidence that exercise programmes probably slightly improve function , may reduce pain , and probably slightly reduce global patient assessment of disease activity , when compared with no intervention , and measured upon completion of the programme .
We found moderate- to low- quality evidence that exercise programmes probably have little or no effect on improving function or reducing pain , when compared with usual care , and may have little or no effect on reducing patient assessment of disease activity , when measured upon completion of the programmes .
We are uncertain whether exercise programmes improve spinal mobility , reduce fatigue , or induce adverse effects
BACKGROUND Exercise programmes are often recommended for managing ankylosing spondylitis ( AS ) , to reduce pain and improve or maintain functional capacity .
OBJECTIVES To assess the benefits and harms of exercise programmes for people with AS .
Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort
Objective To investigate the influence of non-steroidal anti-inflammatory drugs ( NSAIDs ) intake on radiographic spinal progression over 2 years in patients with ankylosing spondylitis ( AS ) and non-radiographic axial spondyloarthritis ( SpA ) . Methods 164 patients with axial SpA ( 88 with AS and 76 with non-radiographic axial SpA ) were selected for this analysis based on availability of spinal radiographs at baseline and after 2 years of follow-up and the data on NSAIDs intake . Spinal radiographs  were scored by two trained readers in a concealed r and omly selected order according to the modified Stoke Ankylosing Spondylitis Spine Score ( mSASSS ) system . An index of the NSAID intake counting both dose and duration of drug intake was calculated . Results High NSAIDs intake ( NSAID index≥50 ) in AS was associated with lower likelihood of significant radiographic progression defined as an mSASSS worsening by ≥2 units : OR=0.15 , 95 % CI 0.02 to 0.96 , p=0.045 ( adjusted for baseline structural damage , elevated C reactive protein ( CRP ) and smoking status ) in comparison with patients with low NSAIDs intake ( NSAID index<50 ) . This effect was most pronounced in patients with baseline syndesmophytes plus elevated CRP : mean mSASSS progression was 4.36±4.53 in patients with low NSAIDs intake versus 0.14±1.80 with high intake , p=0.02 . In non-radiographic axial SpA , no significant differences regarding radiographic progression between patients with high and low NSAIDs intake were found . Conclusion A high NSAIDs intake over 2 years is associated with retarded radiographic spinal progression in AS . In non-radiographic axial SpA this effect is less evident , probably due to a low grade of new bone formation in the spine at this stage
There was no important clinical meaningful benefit .
Adverse effectsWe found very low- quality evidence of the effect of exercise versus either no intervention , or usual care .
We found moderate- to low- quality evidence that exercise programmes probably slightly improve function , may reduce pain , and probably slightly reduce global patient assessment of disease activity , when compared with no intervention , and measured upon completion of the programme .
We found moderate- to low- quality evidence that exercise programmes probably have little or no effect on improving function or reducing pain , when compared with usual care , and may have little or no effect on reducing patient assessment of disease activity , when measured upon completion of the programmes .
We are uncertain whether exercise programmes improve spinal mobility , reduce fatigue , or induce adverse effects
BACKGROUND Exercise programmes are often recommended for managing ankylosing spondylitis ( AS ) , to reduce pain and improve or maintain functional capacity .
OBJECTIVES To assess the benefits and harms of exercise programmes for people with AS .