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Exercise Plus Biologics SpA — SCE Rheumatology MCQ

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EasySpondyloarthropathyExercise Plus Biologics SpASCE Rheumatology

A 42-year-old man with axial spondyloarthritis has achieved a stable response to biologic therapy. He has no acute injury or other contraindication to physical activity and asks whether he should continue his exercise programme. What is the most appropriate advice?

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Correct answer: E — Continue regular exercise alongside biologic therapy, using an individualised structured programme adapted to his symptoms and function

Exercise should continue alongside biologic therapy. Structured exercise and specialist physiotherapy remain core non-pharmacological components of axial spondyloarthritis management; suppression of inflammation with a biologic does not replace work on spinal mobility, posture, strength and aerobic fitness. The programme should be individualised and adjusted to current symptoms, functional capacity and comorbidity. There is no routine requirement to pause exercise while awaiting assessment of biologic response, so B is incorrect. Ordinary daily activity is beneficial but does not necessarily provide the components of a structured programme, excluding C. Hydrotherapy may be used as an adjunct but is not the only permissible form of exercise, excluding D. Exercise is ongoing management rather than a rescue intervention for biologic failure, excluding E.

Reference: National Institute for Health and Care Excellence. Spondyloarthritis in over 16s: diagnosis and management (NG65), section 1.5, recommendation 1.5.1. 2017; guideline updated 2025. https://www.nice.org.uk/guidance/ng65/chapter/Recommendations