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CompletedNCT03290898Updated Mar 15, 2021

REPLACE: Can Exercise Replace Inhaled Corticosteroid Treatment in Asthma? A RCT

An interventional study of High Intensity Interval Training in Asthma, sponsored by Bispebjerg Hospital. Completed at 1 site in Denmark. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2021-03-15.

Sponsored by Bispebjerg Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
150
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

To evaluate if physical exercise intervention leads to an improved asthma control as measured by Asthma Control Questionnaire (ACQ-5) in such a magnitude that inhaled corticosteroid can be reduces in asthmatics.

Read the detailed description

At least 102 asthmatics will be randomized 2:1 (2 to training group; 1 to control) and undergo 6 months of intervention or usual lifestyle.

Subjects must have confirmed asthma diagnosis, on a stable treatment with inhaled corticosteroid, symptomatic and untrained.

At enrollment and during the study asthma medicine is adjusted based on asthma symptoms evaluated by ACQ-5. 6 treatment steps are pre-defined, and if well controlled asthma, subjects are down-titrated one step, if uncontrolled, subjects are uptitrated one step.

02

Conditions studied

  • Asthma

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Keywords

  • Asthma
  • Exercise
  • Asthma treatment
  • Inhaled corticosteroid
  • Rehabilitation
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Asthma (The diagnose of asthma is based on symptoms and at least one positive asthma test the last 5 years (AHR to either mannitol or methacholine, reversibility to beta2-agonist, peak flow variation or positive eucapnic voluntary hyperventilation test))
  • ACQ ≥ 1 and ≤ 2.5
  • On a daily dose of ICS at a minimum of 400 µg budesonide or equivalent ICS for 3 months and with no changes in asthma medicine 4 weeks prior to enrollment
  • Untrained (no participation in vigorous exercise for more than 1 hour per week during the last 2 month)
  • Capable of exercising on bike

Exclusion criteria

Exclusion Criteria:

  • Unable to speak and understand Danish
  • Infection within 4 weeks prior to visit 100*
  • Asthma exacerbation within 4 weeks prior to visit 100*
  • Hospitalized for an asthma attack during the last 2 months
  • Treatment with immunotherapy within 5 T½ of the treatment drug prior to visit 100
  • Initiation of allergen immunotherapy within 3 months prior to visit 100 or plan to begin therapy during study period
  • Treatment with peroral prednisolone
  • Respiratory: other chronic pulmonary disease of clinically significance
  • Cardiovascular: Unstable ischemic heart disease, myocardial infarction within the last 12 months, symptomatic heart failure (NYHA III-IV or EF \<40%), symptomatic heart arrhythmia (documented with ECG), uncontrolled hypertension (>155/100)
  • Pregnancy or breastfeeding or planned pregnancy within the next 12 months
  • Other inflammatory or metabolic diseases with the exception of rhinitis, atopy and well-controlled hypothyroidism treated with or without Eltroxin
  • Vaccination less than 2 weeks prior to any visit
  • Current or former smokers with > 20 pack years
  • Subjects, who by investigators determination, will not be able to adhere to study protocol

    • If patients are excluded due to a recent infection or exacerbation they can undergo re-screening after a total of 4 weeks after end of exacerbation treatment/clearing the infection.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
150 participants (actual)

Study arms

  • Active comparator
    Training group

    Supervised High intensity interval training (HIIT) 3 times a week for 6 months. Training session: 10 minutes warm up (Low-moderate intensity) 30 minutes intervention (16 minutes HIIT) 10 minutes cool down(Low-moderate intensity)

    Behavioral: High Intensity Interval Training

  • No intervention
    Control group

    Control group, usual lifestyle. Aside from training intervention, all other visits are the same as intervention group (training).

Interventions

  • BehavioralHigh Intensity Interval Training

    Training (HIIT)

    Also known as: Training group

05

What researchers measure

Primary outcomes

  1. Reduced inhaled corticosteroid (ICS) 6 months

    The proportion of participants at 6 months that have been down-titrated in ICS dose by at least 25% compared to the participants' baseline dose

    Time frame: 6 months +/- 7 days

Secondary outcomes

  1. Reduced inhaled corticosteroid (ICS) 12 months

    The proportion of participants at 12 months that have been down-titrated in ICS dose by at least 25 % compared to baseline.

    Time frame: 12 months +/- 7 days

  2. Cumulated ICS 6 months

    Change from baseline in cumulated dose of ICS at 6 months

    Time frame: 6 months +/- 7 days

  3. Cumulated ICS 12 months

    Change from baseline in cumulated dose of ICS at 12 months

    Time frame: 12 months +/- 7 days

  4. Cumulated Long acting beta2 agonists (LABA) 6 months

    Change from baseline in cumulated dose of LABA at 6 months

    Time frame: 6 months +/- 7 days

  5. Cumulated LABA 12 months

    Change from baseline in cumulated dose of LABA at 12 months

    Time frame: 12 months +/- 7 days

  6. Exacerbation rate 6 months

    Number of exacerbations (moderate-severe) at 6 months

    Time frame: 6 months +/- 7 days

  7. Exacerbation rate 12 months

    Number of exacerbations (moderate-severe) at 12 months

    Time frame: 12 months +/- 7 days

  8. miniAQLQ 6 months

    Change from baseline in Asthma life quality evaluated by miniAQLQ at 6 months

    Time frame: 6 months +/- 7 days

  9. miniAQLQ 12 months

    Change from baseline in Asthma life quality evaluated by miniAQLQ at 12 months

    Time frame: 12 months +/- 7 days

  10. Fraction of exhaled Nitrogen Oxid 6 months

    Change from baseline in Airway inflammation evaluated by FeNO at 6 months

    Time frame: 6 months +/- 7 days

  11. Fraction of exhaled Nitrogen Oxid 12 months

    Change from baseline in Airway inflammation evaluated by FeNO at 12 months

    Time frame: 12 months +/- 7 days

  12. Sputum cell count 6 months

    Change from baseline in Airway inflammation evaluated by sputum cell count at 6 months

    Time frame: 6 months +/- 7 days

  13. Sputum cell count 12 months

    Change from baseline in Airway inflammation evaluated by sputum cell count at 12 months

    Time frame: 12 months +/- 7 days

  14. Systemic inflammation 6 months

    Change from baseline in systemic inflammation evaluated by blood eosinophilic, hsCRP and inflammatory cytokines (e.g. IL-6 and IL-8) and TNF-alfa at 6 months

    Time frame: 6 months +/- 7 days

  15. Systemic inflammation 12 months

    Change from baseline in systemic inflammation evaluated by blood eosinophilic, hsCRP and inflammatory cytokines (e.g. IL-6 and IL-8) and TNF-alfa at 12 months

    Time frame: 12 months +/- 7 days

  16. Airway hyperresponsiveness

    Change from baseline in airway hyperresponsiveness measured by methacholine test at 6 months

    Time frame: 6 months +/- 7 days

  17. FEV1 6 months

    Change from baseline in lung function evaluated by FEV1 at 6 months

    Time frame: 6 months +/- 7 days

  18. FVC 6 months

    Change from baseline in lung function evaluated by FVC at 6 months

    Time frame: 6 months +/- 7 days

  19. FEV1 12 months

    Change from baseline in lung function evaluated by FEV1 at 12 months

    Time frame: 12 months +/- 7 days

  20. FVC 12 months

    Change from baseline in lung function evaluated by FVC at 12 months

    Time frame: 12 months +/- 7 days

  21. Cardiopulmonary fitness

    Change from baseline in cardiopulmonary fitness evaluated by maximum oxygen consumption at 6 months (VO2max)

    Time frame: 6 months +/- 7 days

  22. Change in fat and muscle composition (DEXA scan)

    Change from baseline in fat and muscle composition evaluated by DEXA scan

    Time frame: 6 months +/- 7 days

Other outcomes

  1. Eosinophilic subpopulation - exploratory analyses 6 months

    To evaluate the effect of the intervention in sub-populations of asthmatics using different cut-off values of blood eosinophilics. Both regarding primary outcome and secondary outcomes.

    Time frame: 6 months +/- 7 days

  2. Eosinophilic subpopulation - exploratory analyses 12 months

    To evaluate the effect of the intervention in sub-populations of asthmatics using different cut-off values of blood eosinophilics with regards to secondary outcomes at 12 months.

    Time frame: 12 months +/- 7 days

06

Study locations

1 site
  • Respiratory Research Unit, Birpebjerg Hospital
    Copenhagen NV, 2400, Denmark
07

References and documents

Study documents

  • Study protocol · Oct 2, 2017
  • Statistical analysis plan · Dec 22, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03290898
Lead sponsor
Bispebjerg Hospital
Responsible party
Vibeke Backer (Professor dr.med., Bispebjerg Hospital) — Principal investigator
First posted
Sep 25, 2017
Start date
Oct 13, 2017
Primary completion
Jun 26, 2020
Completion
Dec 4, 2020
Last update
Mar 15, 2021

Study contacts

Vibeke Backer, professor
principal investigator · Rigshospitalet, Denmark

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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