Use of Axia significantly improves axSpA outcomes

The novel digital therapeutic Axia significantly and clinically improved disease activity, functional ability, and quality-of-life in patients with axial spondyloarthritis (axSpA) compared with standard care. These findings underscore the value of integrating digital therapeutics into routine rheumatological care.

Axia is a novel digital therapeutic specifically designed for patients with axSpA. It consists of a unique algorithm for a patient-tailored, video-based exercise program with over 250 different exercises. Moreover, it delivers disease-specific education and tools for disease self-management and monitoring, such as symptom diaries. A high gamification factor is also included to maximise treatment adherence.

In the randomised, controlled interventional Bechterew-app trial, 200 German adult participants diagnosed with axSpA, with stable pharmacological treatment for at least 8 weeks prior to screening, were assigned to 12 weeks of either Axia intervention or usual care. All patients had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥3.5 at screening.

Among the 186 participants who completed week 12 (95 in the intervention arm and 91 in the control group), Axia led to significantly greater improvements across all primary endpoints. Disease activity decreased substantially, as measured by the BASDAI (-1.66 vs -0.11; P<0.001). Functional ability also improved, as assessed in the Bath Ankylosing Spondylitis Functional Index (BASFI) (-1.12 vs 0.06; P<0.001), as well as quality-of-life according to the Ankylosing Spondylitis Quality of Life questionnaire improved (ASQoL) (-2.51 vs -0.16; P<0.001). “We found a significant and clinically important mean improvement of BASDAI, BASFI, and ASQol in the intervention group, while no differences were seen in the control group”, Dr Patrick-Pascal Strunz (University Hospital of Würzburg, Germany) summarised.

Due to these positive results, a responder analysis was also conducted. Both ASAS20 and ASAS40 response rates were significantly higher in the intervention group than in the control group (51% vs 9% and 23% vs 3%, respectively; P<0.001 for each comparison).

“We were able to show, for the first time, that an app-based intervention can significantly impact disease activity in a rheumatic disease”, concluded Dr Strunz. Axia may soon become Germany's first approved digital therapeutic for a rheumatic disease. Currently, it is only available in German, but additional language versions are being developed.

1. Strunz P-P.The novel digital therapeutic Axia improves disease activity, functionality, and quality of life in axial spondyloarthritis patients: results from a randomised controlled crossover trial (Bechterew-App Trial). LB0002, EULAR 2025, 11–14 June, Barcelona, Spain.

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Posted on 18 June 202518 June 2025