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Patients were randomly allocated into the aerobic or Pilates group. Treatment was performed twice a week for 8\u2009weeks. The primary outcome was the impact of fibromyalgia measured 8\u2009weeks after randomization. Cost\u2010effectiveness and cost\u2010utility analyses were conducted for the impact of fibromyalgia and quality\u2010adjusted life\u2010years (QALYs), respectively, with a 12\u2010month time horizon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference between the groups for the impact of fibromyalgia (MD: 6.5 points; 95% CI: \u22121.8 to 14.9). The incremental cost\u2010effectiveness ratio showed that 1\u2010point increase in the impact of fibromyalgia was on average associated with a societal cost of \u00a356 for the Pilates group compared to the aerobic group. The cost\u2010utility analysis showed that the Pilates group had a 0.71 probability of being cost\u2010effective at a willingness\u2010to\u2010pay of \u00a330,000 per QALY gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There was no significant difference between groups for the impact of fibromyalgia. Pilates was not cost\u2010effective compared to aerobic exercises for the impact of fibromyalgia. However, Pilates seemed to be the preferred option of treatment considering QALYs, although it depends on the willingness\u2010to\u2010pay threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Pilates showed to be a safe and effective alternative for the treatment of patients with fibromyalgia syndrome. Pilates presented similar results for the impact of fibromyalgia and superior results for pain relief compared to aerobic exercises, a highly recommended intervention for the treatment of fibromyalgia syndrome. Pilates was not cost\u2010effective compared to aerobic exercises for the impact of fibromyalgia. However, Pilates seemed to be a cost\u2010effective intervention for QALYs, depending on the decision\u2010maker's willingness\u2010to\u2010pay threshold.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2039","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T07:43:42Z","timestamp":1663055022000},"page":"54-71","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Is Pilates more effective and cost\u2010effective than aerobic exercise in the treatment of patients with fibromyalgia syndrome? 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