Exercise in Juvenile Takayasu Disease

• ClinicalTrials.gov Identifier: NCT03494062
• Recruitment Status: Unknown
• First Posted: April 11, 2018
• Last Update Posted: April 11, 2018
• Sponsor: University of Sao Paulo
• Collaborator: Federal University of São Paulo
• Information provided by (Responsible Party): Bruno Gualano, University of Sao Paulo

Study Description

Brief Summary:

Juvenile Takayasu disease is characterized by chronic inflammation that leads to vascular disease. Exercise may render anti-inflammatory effects and protect against cardiovascular events. This trial aims to investigate the therapeutic role of exercise in juvenile Takayasu disease.

Condition or disease	Intervention/treatment	Phase
Takayasu's Arteritis	Behavioral: Exercise	Not Applicable

Detailed Description:

Takayasu's Arteritis (TA) is a chronic inflammatory disease that affects large and medium-sized arteries. The number of cases describe in children and adolescents has growing, and the hypertension is one of the symptoms most common, followed by other manifestations that affects cardiovascular systems. All clinical manifestations may aggravate by physical inactivity and can creating a vicious cycle of inflammation, whereas the risks of morbidity and mortality increase significantly in the pediatric population, impairing function and physical capacity, quality of life and evolution to adult life. Thereby, physical exercise it is show to be an efficient strategy to reduce all these risk factors, however, no one study, until now, was conducted to available the effects of exercise in children with TA. Objective: Investigated the effects of 12-week home-based exercise program, where the patients receive a guideline from a physical education professional, teaching how to do the exercise at home. The beneficial effects of the programs expect is to be associated with improved cardiovascular risk factors, function and physical capacity, and body composition. Methods: This is a prospective, longitudinal and randomized clinical trial. All patients will be recruited at the Clinical Hospital of the University of Sao Paulo Medical School (HC-FMUSP), in the Laboratory of Evaluation and Conditioning in Rheumatology, Pediatric Rheumatology outpatient clinics of the Department of Pediatrics, Federal University of São Paulo and The Children's Institute of the University of São Paulo and the Vasculitis Unit of the HC-FMUSP Rheumatology Service. In order to evaluate the therapeutic effects of exercise program act on TA, the following pre and post intervention evaluations will be performed: physical activity level; Global clinical evaluation; Anthropometry and body composition; Hematological and inflammatory blood parameters; Cardiovascular risk factors; Aerobic capacity; Functional capacity and fatigue; quality of life; and 18 FDG PET with magnetic resonance angiography.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 21 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Single (Care Provider)
• Primary Purpose: Treatment
• Official Title: Exercise in Juvenile Takayasu Disease: a Randomized Controlled Trial
• Actual Study Start Date: March 5, 2018
• Estimated Primary Completion Date: December 30, 2019
• Estimated Study Completion Date: December 30, 2019

Arms and Interventions

Arm	Intervention/treatment
Experimental: Exercise; Home-based exercise intervention	Behavioral: Exercise; Home-based exercise training
No Intervention: Control; Usual care

Outcome Measures

Primary Outcome Measures :

1. Arterial inflammation [ Time Frame: 12 weeks ]
   as assessed by positron emission tomography - magnetic ressonance (PET-MR)
2. Blood inflammatory markers [ Time Frame: 12 weeks ]
   interleukin-6, interleukin 10, interleukin-12
3. Blood inflammatory marker [ Time Frame: 12 weeks ]
   C-reactive protein
4. velocity sedimentation rate [ Time Frame: 12 weeks ]
   velocity sedimentation rate

Secondary Outcome Measures :

1. Maximal aerobic capacity [ Time Frame: 12 weeks ]
   as assessed by maximal cardiopulmonary test
2. Body composition [ Time Frame: 12 weeks ]
   Lean, fat and bone mass, as assessed by dual energy x-ray absorptiometry
3. Timed stands test [ Time Frame: 12 weeks ]
   The test is performed by measuring the time to stand up and down for 30 seconds. The patient should make two attempts and the best performance will be considered for the analyzes.
4. timed-up-and-go test [ Time Frame: 12 weeks ]
   The "Timed Up-And-Go" test, which evaluates the time it takes for the patient to get up from a chair, walk three meters, make a 180-degree turn, and return to the chair. The patient should perform two attempts and the best performance will be considered for the analyzes.
5. Isometric strength [ Time Frame: 12 weeks ]
   handgrip test
6. Maximal strength test [ Time Frame: 12 weeks ]
   will be performed by the maximum repetition test, where the objective is to find a maximal repetition for lower limbs by leg press exercise 45º and for upper limbs by bench press exercise
7. The Paediatric Vasculitis Activity Score (PVAS) [ Time Frame: 12 weeks ]
   The final PVAS is a clinical index of 64 manifestations of active vasculitis, divided into five domains: general, cutaneous, cardiovascular, abdominal and renal.
8. National Institute of Health (NIH) [ Time Frame: 12 weeks ]
   The NIH criteria is an instrument that will evalueted the disease specific symptoms and his activity. Active disease will arbitrarily defined as new onset or worsening of at least 2 of the following 4 features: (I) signs and symptoms of vascular ischemia or inflammation (e.g. claudication, decreased or absent extremity pulses or blood pressure, bruits, or carotidynia); (2) elevated erythrocyte sedimentation rate; (3) angiographic abnormalities; and (4) systemic symptoms not attributable to another disease.
9. Indian Takayasu's Arteritis Activity Score 2010 (ITAS2010 [ Time Frame: 12 weeks ]
   ITAS2010 contains 44 items with 33 features arising from the cardiovascular system. Seven key items are weighted to score 2 and all others score 1 only.
10. Childhood Health Assessment Questionaire (CHAQ) [ Time Frame: 12 weeks ]
    The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children
11. Physical activity levels [ Time Frame: 12 weeks ]
    The level of physical activity of patients will be measured using the Actigraph GT3x® triaxial accelerometer (Actigraph®).
12. Fatigue severity scale FSS [ Time Frame: 12 weeks ]
    The Fatigue severity scale will be used to monitor the change in fatigue in response to the intervention. For each item, you must tick from 1 totally disagree to 7 agree totally. The total number of points may vary from 9 to 63, and it is established that values equal to or greater than 28 are indicative of the presence of fatigue
13. Quality of life [ Time Frame: 12 weeks ]
    as assessed by Short-Form-36
14. Hypotension after acute exercise session [ Time Frame: 12 weeks ]
    after maximal aerobic capacity, the blood pressure will be will be measured in the four limbs, both arms and legs, every fifteen minutes, for an hour.

Eligibility Criteria

• Ages Eligible for Study: 7 Years to 25 Years (Child, Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• diagnosis of juvenile Takayasu disease

Exclusion Criteria:

• cardiac and renal insufficiency
• physical limitation hampering exercise training
• non-controlled metabolic disorders
• associated chronic diseases (last 6 months)

Contacts and Locations

Contacts

Contact: Camilla CA Astley, Masters; 5511964721104; camilla.astley@gmail.com

Locations

Brazil

University of Sao Paulo; Recruiting

São Paulo, Castanho, Brazil, 05303-000

Contact: Camilla Astley 551126618022 camilla.astley@gmail.com

Sponsors and Collaborators

University of Sao Paulo

Federal University of São Paulo

Investigators

• Principal Investigator: Bruno BG Gualano, Professor; University of Sao Paulo

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Astley C, Clemente G, Terreri MT, Carneiro CG, Lima MS, Buchpiguel CA, Leão Filho H, de Sá Pinto AL, Silva CA, Campos LMA, Aikawa NE, Gil S, Pereira RMR, Roschel H, Gualano B. Home-Based Exercise Training in Childhood-Onset Takayasu Arteritis: A Multicenter, Randomized, Controlled Trial. Front Immunol. 2021 Jul 28;12:705250. doi: 10.3389/fimmu.2021.705250. eCollection 2021.

• Responsible Party: Bruno Gualano, Professor, University of Sao Paulo
• ClinicalTrials.gov Identifier: NCT03494062
• Other Study ID Numbers: Takayasu&Exercise
• First Posted: April 11, 2018
• Last Update Posted: April 11, 2018
• Last Verified: April 2018

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Arteritis; Takayasu Arteritis; Aortic Arch Syndromes; Vasculitis; Vascular Diseases; Cardiovascular Diseases; Aortic Diseases; Skin Diseases, Vascular; Skin Diseases