Exercise and Respiratory Therapy in Patients With Rheumatoid Arthritis / Collagenosis and Pulmonary Hypertension
Primary Purpose
Pulmonary Hypertension, Connective Tissue Disease
Status
Recruiting
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
exercise training
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Hypertension
Eligibility Criteria
Inclusion Criteria:
- Informed consent
- Men and women 18 - 80 years
- Diagnosed rheumatic disease: rheumatoid arthritis, Collagenosis (Systemic Lupus Erythematodes, Systemic Sclerosis, Sjögren-Syndrome, Sharp-Syndrome, Crest-Syndrome, Mixed connective tissue disease)
Symptomatic PAH (WHO- functional class II-IV) invasively diagnosed by right heart catheterisation
- Mean pulmonary artery pressure (mPAP) > 25 mmHg
- Pulmonary capillary wedge pressure (PCWP) > 15 mmHg
- Pulmonary vascular resistance (PVR) at baseline >320 dyn.sec/cm5 patients under optimized medical treatment since at least 2 ½ months
Exclusion Criteria:
- Other forms of PAH.
- Pregnancy or lactation
- Change in medication during the last 2 ½ months
- Patients with signs of right heart decompensation
- Severe impairment of walking
- Unclear diagnosis
- No invasive diagnosis of PH
- Acute illness, infection, fever
- Severe lung disease with FEV1 <50% and TLC< 70% below reference
Sites / Locations
- Thoraxclinic at the University Hospital HeidelbergRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
No Intervention
Arm Label
exercise training group
Control group without exercise training
Arm Description
exercise and respiratory therapy with specific program for pulmonary hypertension (respiratory therapy, dumbbell training, ergometer training, mental training)
continuation of sedentary lifestyle without advice for specific exercise training
Outcomes
Primary Outcome Measures
Change in the 6-minute walking distance
Quality of life (SF-36)
Secondary Outcome Measures
change in inflammatory parameters (BKS, CRP, Leucocytes), change in inflammatory cytokines (TNF-α), change in parameters of the vascular endothelium (Endothelin, PDGF, VEGF), and endothelial progenitor cells
Physical capacity in the cardiopulmonary exercise testing (Watt)
change of peak oxygen consumption and other parameters of cardiopulmonary exercise testing.
hemodynamic parameters: dimension and pump function of the right and the left ventricle.
change in systolic pulmonary arterial pressure at rest and during exercise
echocardiography
change of NTproBNP-value
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00491309
Brief Title
Exercise and Respiratory Therapy in Patients With Rheumatoid Arthritis / Collagenosis and Pulmonary Hypertension
Official Title
Exercise and Respiratory Therapy in Patients With Rheumatoid Arthritis / Collagenosis and Pulmonary Hypertension
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 2011 (undefined)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Heidelberg University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
In Patients with rheumatic disease exercise training is a well established element of therapy. In contrast patients with severe pulmonary hypertension are advised to avoid physical exertion and must not perform exercise training. This study aims to evaluate the effectivity and safety of a low-dose training program in patients with pulmonary hypertension and rheumatic disease.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Hypertension, Connective Tissue Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
45 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
exercise training group
Arm Type
Active Comparator
Arm Description
exercise and respiratory therapy with specific program for pulmonary hypertension (respiratory therapy, dumbbell training, ergometer training, mental training)
Arm Title
Control group without exercise training
Arm Type
No Intervention
Arm Description
continuation of sedentary lifestyle without advice for specific exercise training
Intervention Type
Behavioral
Intervention Name(s)
exercise training
Intervention Description
exercise training with specific program (respiratory therapy, dumbbell training, ergometer training, mental training)
Primary Outcome Measure Information:
Title
Change in the 6-minute walking distance
Time Frame
after 3 weeks and after 15 weeks compared to baseline.
Title
Quality of life (SF-36)
Time Frame
baseline and 15 weeks
Secondary Outcome Measure Information:
Title
change in inflammatory parameters (BKS, CRP, Leucocytes), change in inflammatory cytokines (TNF-α), change in parameters of the vascular endothelium (Endothelin, PDGF, VEGF), and endothelial progenitor cells
Time Frame
baseline and 15 weeks
Title
Physical capacity in the cardiopulmonary exercise testing (Watt)
Time Frame
baseline, 3 weeks, 15 weeks
Title
change of peak oxygen consumption and other parameters of cardiopulmonary exercise testing.
Time Frame
baseline, 3 weeks, 15 weeks
Title
hemodynamic parameters: dimension and pump function of the right and the left ventricle.
Time Frame
baseline, 15 weeks
Title
change in systolic pulmonary arterial pressure at rest and during exercise
Description
echocardiography
Time Frame
baseline, 3 weeks, 15 weeks
Title
change of NTproBNP-value
Time Frame
baseline, 3 weeks, 15 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Informed consent
Men and women 18 - 80 years
Diagnosed rheumatic disease: rheumatoid arthritis, Collagenosis (Systemic Lupus Erythematodes, Systemic Sclerosis, Sjögren-Syndrome, Sharp-Syndrome, Crest-Syndrome, Mixed connective tissue disease)
Symptomatic PAH (WHO- functional class II-IV) invasively diagnosed by right heart catheterisation
Mean pulmonary artery pressure (mPAP) > 25 mmHg
Pulmonary capillary wedge pressure (PCWP) > 15 mmHg
Pulmonary vascular resistance (PVR) at baseline >320 dyn.sec/cm5 patients under optimized medical treatment since at least 2 ½ months
Exclusion Criteria:
Other forms of PAH.
Pregnancy or lactation
Change in medication during the last 2 ½ months
Patients with signs of right heart decompensation
Severe impairment of walking
Unclear diagnosis
No invasive diagnosis of PH
Acute illness, infection, fever
Severe lung disease with FEV1 <50% and TLC< 70% below reference
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ekkehard Gruenig, MD
Phone
+49 6221 396 80 53
Email
ekkehard.gruenig@thoraxklinik-heidelberg.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ekkehard Gruenig, MD
Organizational Affiliation
Thoraxclinic at the University Hospital Heidelberg
Official's Role
Principal Investigator
Facility Information:
Facility Name
Thoraxclinic at the University Hospital Heidelberg
City
Heidelberg
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
69126
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ekkehard Gruenig, MD
12. IPD Sharing Statement
Citations:
PubMed Identifier
22709477
Citation
Grunig E, Maier F, Ehlken N, Fischer C, Lichtblau M, Blank N, Fiehn C, Stockl F, Prange F, Staehler G, Reichenberger F, Tiede H, Halank M, Seyfarth HJ, Wagner S, Nagel C. Exercise training in pulmonary arterial hypertension associated with connective tissue diseases. Arthritis Res Ther. 2012 Jun 18;14(3):R148. doi: 10.1186/ar3883.
Results Reference
derived
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Exercise and Respiratory Therapy in Patients With Rheumatoid Arthritis / Collagenosis and Pulmonary Hypertension
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