TOPLINE:

Patients with axial spondyloarthritis (axSpA) who used a smartphone application called Axia alongside standard care reported greater improvements in disease activity, physical function, and disease-specific quality of life over 12 weeks than those who received standard care alone.

METHODOLOGY:

• Researchers in Germany conducted a remote randomized controlled trial (March-December 2024) to test whether adding the Axia smartphone app to standard care improved disease activity, function, and quality of life in patients with axSpA.
• They enrolled 200 adults with axSpA who had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 3.5, were on stable antirheumatic therapy for at least 8 weeks, and were not highly physically active.
• Patients were randomly assigned to either use the Axia app with standard care or receive standard care alone (control group). The app offered tailored home-based exercises, education, self-management tools, and adherence features such as daily routines, milestones, step goals, and smartwatch integration.
• Co-primary endpoints at 12 weeks were changes in patient-reported disease activity measured using the BASDAI, physical function measured using the Bath Ankylosing Spondylitis Functional Index (BASFI), and disease-specific quality of life measured using the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Various other endpoints including pain, adherence, rates of 20% and 40% improvement on Assessment of Spondyloarthritis International Society response criteria (ASAS20 and ASAS40), and adverse events were also assessed.
• A total of 186 participants completed the 12-week assessment; their mean age was about 50.5 years, and 66% were female.

TAKEAWAY:

• The Axia user group reported greater reductions than the control group in scores for the BASDAI (group difference, -1.508; P < .001), BASFI (group difference, -1.139; P < .001), and ASQOL (group difference, -2.297; P < .001), all exceeding their respective thresholds for minimal clinically important differences.
• A higher proportion of participants in the Axia user group than those in the control group achieved ASAS20 response (51% vs 9%) and ASAS40 response (23% vs 3%; P < .001 for both).
• Pain, patient global assessment, self-efficacy, and self-reported exercise adherence improved more in the Axia user group than in the control group. Axia users used the app for a mean of 69 days and a mean total of 1145 minutes; 77.9% used it for at least 5 days per week, and 98.9% opted to continue.
• No device-related adverse events were reported. Overall adverse events were fewer with the app than with standard care alone (22% vs 37%), and serious adverse events were rare.

IN PRACTICE:

“The underlying therapeutic approach — disease-specific, adaptive exercise combined with patient education, behavioral support, and gamification elements — represents a framework that could be adapted for other [inflammatory rheumatic and musculoskeletal diseases] in which exercise and self-management are integral to care, but long-term adherence is suboptimal,” the authors of the study wrote.

“These findings support the potential of mobile healthcare apps to complement existing pharmacological and nonpharmacological treatments and help close the gap between guideline-based exercise recommendations and their limited implementation in routine care,” they added.

SOURCE:

The study was led by Patrick-Pascal Strunz, MD, University Hospital Wuerzburg, Wuerzburg, Germany. It was published online on March 12, 2026, in Annals of the Rheumatic Diseases.

LIMITATIONS:

The trial was not double-blinded and lacked a placebo control. Researchers relied solely on patient-reported measures without objective clinical or biomarker data. The 12-week remote design was short and did not capture long-term sustainability or fully document comorbidities.

DISCLOSURES:

The study did not receive any specific grant from funding agencies. Axia was developed and supplied free for the trial by Applimeda GmbH. Some authors reported having financial relationships with industries such as receiving speaker fees, travel support, consultancy or research funding, and/or having equity or employment ties with Applimeda GmbH.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.