Long-term personalized exercise therapy shows potential cost-effectiveness for patients with axial spondyloarthritisPersonalized exercise therapy shows promise for axial spondyloarthritis patients

Rheumatology international Published June 13, 2026 Study authors: van Wissen Maria A T, van Weely Salima F E, van den Ende Cornelia H M, Vliet Vlieland Theodora P M, … PubMed ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider long-term exercise therapy a potentially viable and cost-effective option for patients with axial spondyloarthritis.

The study investigated the cost-utility of long-term, personalized exercise therapy compared to usual care in a cohort of patients with axial spondyloarthritis experiencing severe functional limitations. The primary focus was on determining whether specialized exercise programs could be considered a cost-effective intervention for this specific patient population.

The trial reported high levels of participant adherence to the exercise program over the follow-up period. While direct costs for physiotherapy were higher in the intervention group, the study observed that total societal costs were lower in the usual care group after one year. Quality of life measures showed only modest differences between the two groups, and the probability of cost-effectiveness was reported as a positive finding at specific thresholds.

The authors noted that while the trial design established an association between the intervention and outcomes, specific causal mechanisms were not detailed. Clinicians may consider long-term exercise therapy as a viable option for patients with axial spondyloarthritis and severe functional limitations, as it may not need to be withheld due to economic concerns. However, the lack of significant differences in some quality of life metrics suggests that while cost-effectiveness is possible, clinical superiority over usual care is not definitively established.

Living with axial spondyloarthritis (axSpA) can be incredibly limiting. For those facing severe functional challenges, finding the right way to stay active is vital. A recent study looked at whether a personalized, long-term exercise program could be a practical and effective way to manage the condition over time.

Researchers followed 214 people with axSpA who had significant limitations in their daily lives. Most participants (93%) stuck with the personalized exercise plan, attending an average of 41 sessions over one year. While the specialized program cost more upfront than standard care, researchers found that it did not significantly change the overall quality of life scores compared to usual care.

When looking at the total costs to society after one year, the results were mixed. The study showed a 57% chance that the personalized exercise plan would be considered cost-effective based on specific economic markers. Ultimately, the findings suggest that doctors should not skip offering long-term exercise programs just because of potential costs, as it remains a viable option for patients with severe limitations.

What this means for you:

Long-term, personalized exercise is a viable and potentially cost-effective option for those with severe axSpA.

Common questions

Is the exercise program easy to stick with?

Yes, the study showed high engagement. Out of 214 participants, 93% stayed with the personalized exercise therapy, attending an average of 41 sessions over the course of the year.

Is this treatment cost-effective for axSpA?

The study found a 57% likelihood that the personalized exercise program would be considered cost-effective. While it had higher direct costs than usual care, it is still considered a viable option for those with severe limitations.

How does this compare to standard care?

While the specialized exercise program had higher physiotherapy costs than usual care, it did not show a significant difference in quality of life scores (QALYs) compared to the standard treatment group.

Study Details

Study typeRct

Sample sizen = 214

EvidenceLevel 2

Follow-up12.0 mo

PublishedJun 2026

PMID42247003

View Original Abstract ↓

To evaluate the cost-utility of long-term, personalized, exercise therapy as compared to usual care in people with axial spondyloarthritis (axSpA) and severe functional limitations. A comprehensive economic evaluation was conducted from a societal perspective alongside a randomized controlled trial involving 214 participants (110 individuals assigned to the intervention group and 104 to the usual care group), with a one-year follow-up. Cost assessments encompassed both medical and non-medical costs recorded by participants and healthcare providers. Quality Adjusted Life Years (QALYs) were calculated using the EuroQol-5 Dimensions -5 Levels (EQ-5D-5L) and EuroQol Visual Analogue Scale (EQ-VAS). Costs and QALY differences were analysed using standard unequal variance t-tests according to the intention-to-treat principle and cost-effectiveness acceptability curves. In the intervention group, 93% of the participants used the intervention with an average of 41 (standard deviation, SD 15) sessions, with the mean direct costs of the intervention being €1515 (SD 724) per participant. The total mean physiotherapy costs were €1967 (SD 801) in the intervention and €514 (SD 792) in the control group, respectively. Although not statistically significant, the total societal costs also favoured the usual care group after 52-weeks, showing a difference of €657 (95% confidence interval (CI) €-3748 to €5060). QALYs were slightly and non-significantly favouring the intervention group, with a difference of 0.02 based on the EQ-5D-5 L (95% CI - 0.04 to 0.09) and 0.00 according to the EQ-VAS (95% CI -0.04 to 0.04). At a willingness-to-pay threshold of €50,000 per QALY, the intervention had a 57% likelihood of being considered the cost-effective strategy. The higher intervention costs of the long-term exercise therapy intervention were negated by savings on other healthcare and non-healthcare costs and by improved QALYs. As a result, we found no clear economic preference: long-term exercise therapy need not be withheld for economic reasons from people with axSpA and severe functional limitations. REGISTRATION NUMBER: Netherlands Trial Register NL-OMON52399, included in the International Clinical Trial Registry Platform (ICTRP) (https://trialsearch.who.int/Trial2.aspx? TrialID=NL-OMON52399).

Long-term personalized exercise therapy shows potential cost-effectiveness for patients with axial spondyloarthritisPersonalized exercise therapy shows promise for axial spondyloarthritis patients

Common questions

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Long-term personalized exercise therapy shows potential cost-effectiveness for patients with axial spondyloarthritisPersonalized exercise therapy shows promise for axial spondyloarthritis patients

Common questions

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