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An add-on training program involving breathing exercises, cold exposure, and meditation attenuates inflammation and disease activity in axial spondyloarthritis - A proof of concept trial.

PloS one
May 5, 2019
G A Buijze et al. (9 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to assess the safety and anti-inflammatory effects of a training program involving cold exposure, breathing exercises, and meditation in patients with axial spondyloarthritis.

Results Summary

The study found no significant safety concerns during the intervention, with a significant decline in ESR levels and ASDAS-CRP in the intervention group, though no effect was observed for hs-CRP.

Population

Patients with moderately active axial spondyloarthritis (ASDAS >2.1 and hs-CRP ≥5mg/L).

Effective Dosage

Not specified

Duration

8 weeks

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
add-on training program involving breathing exercises, cold exposure, and meditation
no change
safety
patients with axial spondyloarthritis
null
no significant differences in adverse events
#1
add-on training program involving breathing exercises, cold exposure, and meditation
decrease
ESR
patients with axial spondyloarthritis
from (median [interquartile range] to 16 [9-26.5] to 9 [5-23] mm/hr
significant decline
#2
add-on training program involving breathing exercises, cold exposure, and meditation
decrease
ASDAS-CRP
patients with axial spondyloarthritis
from 3.1 [2.5-3.6] to 2.3 [1.9-3.2]
declined
#3
add-on training program involving breathing exercises, cold exposure, and meditation
decrease
serum calprotectin
patients with axial spondyloarthritis
null
similar trend was observed
#4
add-on training program involving breathing exercises, cold exposure, and meditation
no change
hs-CRP
patients with axial spondyloarthritis
null
no effect was found
#5
Abstract

OBJECTIVES: The primary objective of this trial was to assess safety and anti-inflammatory effects of an add-on training program involving breathing exercises, cold exposure, and meditation in patients with axial spondyloarthritis. METHODS: This study was an open-label, randomised, one-way crossover clinical proof-of-concept trial. Twenty-four patients with moderately active axial spondyloarthritis(ASDAS >2.1) and hs-CRP ≥5mg/L were included and randomised to an intervention (n = 13) and control group (n = 11) group that additionally received the intervention after the control period. The intervention period lasted for 8 weeks. The primary endpoint was safety, secondary endpoints were change in hs-CRP, serum calprotectin levels and ESR over the 8-week period. Exploratory endpoints included disease activity measured by ASDAS-CRP and BASDAI, quality of life (SF-36, EQ-5D, EQ-5D VAS), and hospital anxiety and depression (HADS). RESULTS: We found no significant differences in adverse events between groups, with one serious adverse event occurring 8 weeks after end of the intervention and judged 'unrelated'. During the 8-week intervention period, there was a significant decline of ESR from (median [interquartile range] to 16 [9-26.5] to 9 [5-23] mm/hr, p = 0.040, whereas no effect was found in the control group (from 14 [8.3-27.3] to 16 [5-37] m/hr, p = 0.406). ASDAS-CRP declined from 3.1 [2.5-3.6] to 2.3 [1.9-3.2] in the intervention group (p = 0.044). A similar trend was observed for serum calprotectin (p = 0.064 in the intervention group versus p = 0.182 in the control group), but not for hs-CRP. CONCLUSIONS: This proof-of-concept study in axial spondyloarthritis met its primary endpoint with no safety signals during the intervention. There was a significant decrease in ESR levels and ASDAS-CRP upon the add-on training program in the intervention group. These findings warrant full-scale randomised controlled trials of this novel therapeutic approach in patients with inflammatory conditions. TRIAL REGISTRATION: ClinicalTrials.gov; NCT02744014.

Medical Subject Headings (MeSH)
AdultBiomarkersBreathing ExercisesCold TemperatureEndpoint DeterminationFemaleHumansInflammationMaleMeditationProof of Concept StudySpondylarthritis
Study Links
Quality Scores
Safety85
Efficacy70/10
Quality75/10
Citation Metrics
Total Citations19
Citations/Year3.2
Relative Citation Ratio1.45
NIH Percentile63.8%
Research Impact Scores
APT Score0.75
Weight Score2.18
Normalized Score0.77
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