AB0911 APP-BASED (DIGA) BACK PAIN TREATMENT IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS OF A RANDOMIZED CONTROLLED TRIAL
Authors: P. Palm von Alten Blaskowitz, A. M. Liphardt, B. Coppers, C. Bouzas, V. Bundle, S. Rudolf, J. Knitza, M. G. Raimondo, H. Labinsky, L. Hatscher, A. Wirsching, D. Bohr, E. Araujo, A. M. Ramming, A. Ramming, G. Schett, H. Morf
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Axial spondyloarthritis (axSpA) is an inflammatory autoimmune disease that can lead to restricted mobility, spinal deformities and pain, especially in the lower back. In addition to treatment with anti-inflammatory and pain-relieving medications, physical therapy is considered the gold standard for reducing pain and improving patient`s mobility as recommended by the updated EULAR guidelines for physical therapy in inflammatory arthritis. Digital health application (DiGA) have recently gained more interest in rheumatology. Exercise-oriented DiGAs in particular can lead to a more active participation of patients, motivate to physical activity and increase adherence to therapy. The DiGA ViViRA is specially developed for patients with back pain. <h3>Objectives:</h3> The aim of this study is to investigate the additive effect of non-pharmacological treatment on spinal mobility and pain during training with a DiGA for 12-weeks in patients with spondyloarthritis. <h3>Methods:</h3> Patients with axial spondyloarthritis according to the classification criteria of the Assessment of SpondyloArthritis international Society (ASAS) and persisting back pain (numeric pain rating scale &gt; 4/10) participated in this randomized controlled study (DRKS00031254). The intervention group trained with the ViViRA health application (at least three times/week for 15 minutes over 12 weeks) while the control group underwent physical therapy (once/week). Patient perceived disease activity was assessed by patients global assessment for disease activity (visual analog scale, VAS global (range: 0 to 10)), pain by PAIN-Detect (range: 0 to 38) and patient´s numeric pain rating scale (NRS (range: 0 to 10)), mobility by BASMI (Bath ankylosing spondylitis metrology index; range: 0 to 10) and modified Schober-test, physical and psychological quality of life by short form (SF)-36 (range: 0 to 100) before (Visit 1) and after the 12-weeks (Visit 2). Statistical analysis was performed using SPSS Statistics 20 Windows (SPSS Inc., Chicago, Illinois, USA). After testing for normal data distribution (Shapiro Wilk test), data analysis was performed using the t-test (normal distribution) or the Wilcoxon test (no normal distribution) for related variables (Visit1: baseline Visit 2: follow-up at 12 weeks). <i>p</i> values were two-sided and considered statistically significant if ≤ 0.05. All results are reported as means±standard deviation (SD). <h3>Results:</h3> Data of 30 participants in the intervention group (female = 21 (70 %); 43.13 years ± 11.25; BMI 27.23 ± 5.28) was included in this analysis. Mobility measured by BASMI (baseline: 1.12 ± 1.1 vs. follow-up: 0.95 ± 1, p=0.002), modified Schober-test (baseline: 13.59 cm ± 3.92 vs. follow-up: 14.49 cm ± 4.01, p &lt; 0.05) and physical SF-36 (baseline: 38.68 ± 11.61 vs. follow-up: 42.9 ± 10.77, p &lt; 0.05) improved in the intervention group. However, there was an increase of patient global assessment for disease activity (baseline: 5 ± 2.86 vs. follow-up: 3.57 ± 2.46, p=0.011) and no significant improvement in pain. <h3>Conclusion:</h3> Regular exercise therapy, as described above using the DiGA ViViRA can significantly improve the mobility and physical quality of life of patients with axSpA. However, there was no improvement in terms of pain. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This work was partly funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1483 – Project-ID 442419336, EmpkinS and the University Hospital Erlangen (ELAN – P089 - Project-ID). <h3>Disclosure of Interests:</h3> Paloma Palm von Alten Blaskowitz: None declared, Anna-Maria Liphardt: None declared, Birte Coppers: None declared, Claudia Bouzas: None declared, Vanessa Bundle: None declared, Sebastian Rudolf: None declared, Johannes Knitza: None declared, Maria Gabriella Raimondo: None declared, Hanna Labinsky: None declared, Lukas Hatscher: None declared, Andreas Wirsching: None declared, Daniela Bohr: None declared, Elizabeth Araujo: None declared, Alina M Ramming: None declared, Andreas Ramming: None declared, Georg Schett: None declared, Harriet Morf Novartis, Galapagos, Gsk, UCB, Abbvie.