DDI-relevance was established regardless of whether the relevant enzymes were presented or not

ced in the EG compared to CG. The PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19717844 median changes in Alx and PWV for the EG and CG are presented in Safety Seven of 10 subjects in the EG had decreased disease activity, one had a stable disease activity and two increased their disease activity from baseline to post intervention. AIx, Augmentation Index; BMI, body mass index; DBP, diastolic blood pressure; HR, heart rate; HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol; PWV, Pulse Wave Velocity; SBP, systolic blood pressure; TC, total cholesterol; VO2 peak, peak oxygen uptake. a Estimated regression coefficients; b analyzing only subjects with an increased waist circumference at baseline, c Hodges-Lehman median estimator, d Mann-Whitney U-test. doi:10.1371/journal.pone.0108688.t003 6 High Intensity Exercise in Axial Spondyloarthritis adverse events were reported during the intervention, indicating that high intensity exercise was safe and well tolerated in patients with active axSpA. Discussion This pilot study showed that high intensity endurance and strength exercise improved disease activity and reduced CV-risk factors in axSpA patients with active disease. To our knowledge this is the first study aiming to examine whether patients with active axSpA could participate in a high intensity exercise program without a flare up in disease activity. Given the 345627-80-7 web treatment effect of improved patient reported disease activity and stable inflammatory markers, the concept of high intensity exercise for axSpA-patients with active disease seems to be applicable. Our results are in accordance with a recently published case matched study by Stavropoulos-Kalinoglou et al. reporting that high intensity exercise significantly improved disease activity in patient with rheumatoid arthritis . BASDAI has commonly been used as disease activity outcome measure in studies of effects of medication or exercise in patients with AS. Systematic reviews have reported treatment effects of TNF-inhibitors with effect size between 0.3 and 1.5, and ES of exercise therapy to be between 0 and 0.8 in BASDAI. In comparison, we found an ES of 1.4, suggesting that the intervention may have beneficial effects on patient reported disease symptoms. Thus, the improvement in BASDAI in our study supports that high intensity exercise may serve as an effective supplement to a pharmacological intervention. Increased CV risk is an important factor for increased morbidity and mortality in patients with rheumatic diseases including those PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19718802 with axSpA. In the present study we found improvements in several CV risk factors. Central arterial stiffness measured as PWV is a validated marker of CV risk and has been used as a surrogate endpoint of CVD. AIx is an estimation of central arterial pressure and has also been shown to predict CV mortality. This is the first study to demonstrate improvements of arterial stiffness after exercise intervention in patients with axSpA, and in rheumatic diseases in general. However, improvement in arterial stiffness after an exercise intervention has been reported in young and middle aged healthy men, and a cross-sectional study on RA patients reported that a higher level of self-reported physical activity was associated with lower arterial stiffness. The magnitude of the reduction in arterial stiffness in the exercise group was AIx 3% and PWV 0.4 m/s, which is comparable to the reduction reported in studies on other populations. A population study has shown that in young m