Abstract
Background and objectives: The main objective of this study is to highlight the efficiency of different therapeutic means in patients with ankylosing spondylitis, resulting in the improvement of their quality of life. Materials and Methods: We conducted a randomized, longitudinal, controlled trial on 92 patients with ankylosing spondylitis over a period of 6 years. Disease activity was assessed using the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) score. The assessment of functional disabilities was performed using BASFI (Bath Ankylosing Spondylitis Functional Index). We assessed the quality of life using the HAQ questionnaire (Health Assessment Questionnaire). Based on the HAQ, we calculated the minimum number of patients to be treated for 52 weeks to prevent a decrease in the quality of life for at least one of them (the number needed to treat (NNT)). Results: For the combination therapy group, the result we obtained was 2, lower than the other therapies compared (the medication group and the group with physical exercise). We point out a correlation between the improvement of the functional status (BASFI) and the increase of the quality of life (HAQ), estimated as moderately high (0.8). The superiority of the effects of the combined treatment, in which we combined a nonsteroidal anti-inflammatory drug (etoricoxib) to the exercise program, is reflected by the model of the significant improvements (p < 0.05) obtained for the functional status and quality of life scores (BASFI and HAQ). Conclusions: The nonsteroidal anti-inflammatory drugs, in our case, etoricoxib, facilitate the application of individualized exercise programs in patients with ankylosing spondylitis.
Highlights
In the few last years, at an international level, there has been an increase in the number of cases diagnosed with ankylosing spondylitis (AS)
A first evaluation was the one regarding the markers of inflammation: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
To assess the effect of various therapies on the functional status of patients with ankylosing spondylitis, we calculated the difference between the average values of BASFI at the end of the study (T4) and those from the initial moment (T1)
Summary
In the few last years, at an international level, there has been an increase in the number of cases diagnosed with ankylosing spondylitis (AS). Physical rehabilitation treatment, a basic therapeutic treatment recommended for patients with ankylosing spondylitis, does not benefit from the same clear rules of application, and its effectiveness has not yet been correctly evaluated through extensive clinical studies [12]. By identifying the optimal exercise program to improve functional capacity, the results obtained will have substantial clinical and health implications for the patients with ankylosing spondylitis [13]. The superiority of the effects of the combined treatment, in which we combined a nonsteroidal anti-inflammatory drug (etoricoxib) to the exercise program, is reflected by the model of the significant improvements (p < 0.05) obtained for the functional status and quality of life scores (BASFI and HAQ). Conclusions: The nonsteroidal anti-inflammatory drugs, in our case, etoricoxib, facilitate the application of individualized exercise programs in patients with ankylosing spondylitis
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