title: Concurrent Intervention With Exercises and Stabilized Tumor Necrosis Factor Inhibitor Therapy Reduced the Disease Activity in Patients With Ankylosing Spondylitis: A Meta-Analysis.
abstract: Since the use of tumor necrosis factor (TNF) inhibitor therapy is becoming wider, the effects of concurrent intervention with exercises and stabilized TNF inhibitors therapy in patients with ankylosing spondylitis (AS) are different. The study aimed to objectively evaluate whether concurrent intervention with exercises and stabilized TNF inhibitors can reduce the disease activity in patients with AS. A search from PubMed, Web of Science, EMBASE, and the Cochrane Library was electronically performed to collect studies which compared concurrent intervention with exercise and TNF inhibitor to conventional approach in terms of disease activity in patients with AS published from their inception to June 2015. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), and chest expansion as outcomes were included. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Quantitative analysis was performed with Review Manager (RevMan) software (version 5.3.0). A total of 5 studies comprising 221 participants were included in the study. Meta-analyses showed that concurrent intervention with exercises and stabilized TNF inhibitors therapy significantly reduced the BASMI scores (MD, -0.99; 95% CI, -1.61 to -0.38) and BASDAI scores (MD, -0.58; 95% CI, -1.10 to -0.06), but the BASFI scores (MD, -0.31; 95% CI, -0.76 to 0.15) was not reduced, and chest expansion (MD, 0.80; 95% CI, -0.18 to 1.78) was not increased. Concurrent intervention with exercises and stabilized TNF inhibitors therapy can reduce the disease activity in patients with AS. More randomized controlled trials (RCTs) with high-quality, large-scale, and appropriate follow-up are warranted to further establish the benefit of concurrent intervention with exercises and TNF inhibitors for this given population due to some limitations impaired the power of our study.
authors.affiliation: From the School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China (HL, W-RL, HZ, C-MW); Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China (XT); School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China (XT); and Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China (WW).
authors.forename: Hui
authors.initials: H
authors.lastname: Liang
authors.forename: Wen-Rong
authors.initials: WR
authors.lastname: Li
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.forename: Xu
authors.initials: X
authors.lastname: Tian
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Chun-Mei
authors.initials: CM
authors.lastname: Wang
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D013167:Spondylitis, Ankylosing / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha