Combination treatment with etanercept and an intensive spa rehabilitation program in active ankylosing spondylitis

Int J Immunopathol Pharmacol. 2009 Oct-Dec;22(4):1125-9. doi: 10.1177/039463200902200430.


The aim of this study is to determine the effects of a combination treatment with etanercept and spa rehabilitation versus etanercept alone on function, disability and quality of life in a group of patients with active ankylosing spondylitis (AS). Sixty patients with AS underwent etanercept as suggested by ASAS/EULAR recommendations. As the clinical and laboratory conditions improved, 30 patients accepted the proposal of coupling the medical therapy with a 7-day rehabilitation program in a thermal baths centre; the remaining 30 subjects continued to take the biologic agent alone. The comparisons between the 2 groups were made after 3 and 6 months. The primary outcome was an improvement in BASFI. The secondary outcome was an improvement in the visual analogic scale of EuroQol (EQ-5Dvas). After 6 months a statistically significant improvement in BASFI (p < 0.05) and EQ-5DVAS (p < 0.05) scores was observed in both groups. The mean change in EQ-5DVAS value showed a statistically significant difference in favour of the combination therapy group versus the monotherapy group (22 vs 32, p < 0.05). A therapeutic regimen combining etanercept with an intensive rehabilitation program contributes to disability reduction and ameliorates quality of life for AS patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Letter
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Balneology*
  • Combined Modality Therapy
  • Disability Evaluation
  • Etanercept
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Middle Aged
  • Quality of Life
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Recovery of Function
  • Spondylitis, Ankylosing / drug therapy*
  • Spondylitis, Ankylosing / physiopathology
  • Spondylitis, Ankylosing / rehabilitation*
  • Time Factors
  • Treatment Outcome


  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Etanercept