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 .
Radiographic findings following two years of infliximab therapy in patients with ankylosing spondylitis.
OBJECTIVE To evaluate the effect of infliximab on progression of structural damage over 2 years in patients with ankylosing spondylitis ( AS ) . METHODS In the Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy ( ASSERT ) , a r and omized , double-blind , placebo-controlled trial of the efficacy of infliximab compared with placebo , 279 patients with active AS received either placebo through week 24 and then infliximab 5 mg/kg from week 24 through week 96 ( n=78 ) or infliximab 5 mg/kg from baseline through week 96 , administered every 6 weeks after a loading dose ( n=201 ; these patients were the focus of the radiographic analyses ) . Radiographic findings  in patients from the ASSERT trial were indistinguishable from those in a historical control cohort of patients who had no prior use of anti-tumor necrosis factor agents ( from the Outcome in Ankylosing Spondylitis International Study [ OASIS ] data base ; n=192 ) . Radiographic progression of structural damage from baseline to the 2-year followup was scored using the modified Stoke Ankylosing Spondylitis Spine Score ( mSASSS ) . All images were scored in one batch . RESULTS Median changes in the mSASSS from baseline to year 2 were 0.0 for both the OASIS and the ASSERT cohorts ( P=0.541 ) . Mean changes in the mSASSS were also similar between the OASIS and ASSERT cohorts ( mean+/-SD change over 2 years 1.0+/-3.2 and 0.9+/-2.6 , respectively ) . In addition , results from sensitivity analyses did not show a statistically significant difference in the mSASSS between the OASIS and ASSERT cohorts . CONCLUSION AS patients who received infliximab from baseline through week 96 did not show a statistically significant difference in inhibition of structural damage progression at year 2 , as assessed using the mSASSS scoring system , when compared with radiographic data from the historical control OASIS cohort . Improvements in clinical outcomes and spinal inflammation have been previously demonstrated with the use of infliximab therapy
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 .