Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol

Introduction Biologic and small-molecule therapies have revolutionised the treatment of moderate-to-severe inflammatory bowel disease (IBD). A significant proportion of patients experience early or delayed treatment failure. Patients with IBD with greater visceral obesity are less likely to respond...

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Main Authors: Noel McCaffrey, Karen Boland, Neasa Mc Gettigan, Marion Hanley, Fiona Skelly, Jennifer Dowling, Ruth Dunne, Martina M Morrin, Aoibhlinn O'Toole
Format: Article
Language:English
Published: BMJ Publishing Group 2022-10-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/9/1/e000959.full
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author Noel McCaffrey
Karen Boland
Neasa Mc Gettigan
Marion Hanley
Fiona Skelly
Jennifer Dowling
Ruth Dunne
Martina M Morrin
Aoibhlinn O'Toole
author_facet Noel McCaffrey
Karen Boland
Neasa Mc Gettigan
Marion Hanley
Fiona Skelly
Jennifer Dowling
Ruth Dunne
Martina M Morrin
Aoibhlinn O'Toole
author_sort Noel McCaffrey
collection DOAJ
description Introduction Biologic and small-molecule therapies have revolutionised the treatment of moderate-to-severe inflammatory bowel disease (IBD). A significant proportion of patients experience early or delayed treatment failure. Patients with IBD with greater visceral obesity are less likely to respond to biologics. Sarcopenia has been identified as a predictor of disease severity and need for rescue therapy in acute severe ulcerative colitis. The aim of this study is to assess the feasibility of a physician-derived exercise programme in patients with IBD commencing biologic or small-molecule therapy in addition to the effect on physical fitness, body composition and objective measures of quality of life, fatigue scores and disease activity.Methods and analysis This is a randomised controlled feasibility study comparing the effects of a physician-derived exercise programme and standard medical care (biologic/small-molecule therapy) with standard care alone in patients with moderate to severe IBD. Patients with IBD in the intervention group will undergo a structured exercise programme for 20 weeks. Both IBD groups will carry out body composition, disease activity and quality-of-life assessments at baseline, week 12 and week 26. The primary objective is to assess the feasibility of the physician-derived exercise programme in patients with IBD commencing disease-modifying therapies. Secondary endpoints include a change in cardiorespiratory fitness, disease activity/inflammation, fatigue, health-related quality of life outcomes and body composition between the two IBD groups. Exploratory endpoints include validation of anterior thigh ultrasound for sarcopenia screening, assessment of proinflammatory cytokines and markers of immunometabolism.Ethics and dissemination This study has received ethical approval from the Beaumont Hospital Ethics committee on 22 October 2021 (reference number 21/21). Data generated or analysed during this study will be published as an article and supplementary appendix in relevant medical journals. The data will also be presented at national and international conferences.Trial registration number NCT05174754.
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spelling doaj-art-313680bcced14702999bea2851dda5fd2025-08-20T02:40:17ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742022-10-019110.1136/bmjgast-2022-000959Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocolNoel McCaffrey0Karen Boland1Neasa Mc Gettigan2Marion Hanley3Fiona Skelly4Jennifer Dowling5Ruth Dunne6Martina M Morrin7Aoibhlinn O'Toole8ExWell Medical, Irish Wheelchair Association, Dublin, IrelandDepartment of Gastroenterology, Beaumont Hospital, Dublin, IrelandDepartment of Gastroenterology, Beaumont Hospital, Dublin, IrelandDepartment of Radiology, Beaumont Hospital, Dublin, IrelandDepartment of Sport and Health Sciences, Technological University of the Shannon (TUS), Westmeath, IrelandDepartment of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, IrelandDepartment of Radiology, Beaumont Hospital, Dublin, IrelandDepartment of Radiology, Beaumont Hospital, Dublin, IrelandDepartment of Gastroenterology, Beaumont Hospital, Dublin, IrelandIntroduction Biologic and small-molecule therapies have revolutionised the treatment of moderate-to-severe inflammatory bowel disease (IBD). A significant proportion of patients experience early or delayed treatment failure. Patients with IBD with greater visceral obesity are less likely to respond to biologics. Sarcopenia has been identified as a predictor of disease severity and need for rescue therapy in acute severe ulcerative colitis. The aim of this study is to assess the feasibility of a physician-derived exercise programme in patients with IBD commencing biologic or small-molecule therapy in addition to the effect on physical fitness, body composition and objective measures of quality of life, fatigue scores and disease activity.Methods and analysis This is a randomised controlled feasibility study comparing the effects of a physician-derived exercise programme and standard medical care (biologic/small-molecule therapy) with standard care alone in patients with moderate to severe IBD. Patients with IBD in the intervention group will undergo a structured exercise programme for 20 weeks. Both IBD groups will carry out body composition, disease activity and quality-of-life assessments at baseline, week 12 and week 26. The primary objective is to assess the feasibility of the physician-derived exercise programme in patients with IBD commencing disease-modifying therapies. Secondary endpoints include a change in cardiorespiratory fitness, disease activity/inflammation, fatigue, health-related quality of life outcomes and body composition between the two IBD groups. Exploratory endpoints include validation of anterior thigh ultrasound for sarcopenia screening, assessment of proinflammatory cytokines and markers of immunometabolism.Ethics and dissemination This study has received ethical approval from the Beaumont Hospital Ethics committee on 22 October 2021 (reference number 21/21). Data generated or analysed during this study will be published as an article and supplementary appendix in relevant medical journals. The data will also be presented at national and international conferences.Trial registration number NCT05174754.https://bmjopengastro.bmj.com/content/9/1/e000959.full
spellingShingle Noel McCaffrey
Karen Boland
Neasa Mc Gettigan
Marion Hanley
Fiona Skelly
Jennifer Dowling
Ruth Dunne
Martina M Morrin
Aoibhlinn O'Toole
Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
BMJ Open Gastroenterology
title Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
title_full Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
title_fullStr Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
title_full_unstemmed Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
title_short Impact of a physician-led exercise programme on quality of life, muscle mass and clinical response in inflammatory bowel disease patients during induction with disease-modifying therapy: a study protocol
title_sort impact of a physician led exercise programme on quality of life muscle mass and clinical response in inflammatory bowel disease patients during induction with disease modifying therapy a study protocol
url https://bmjopengastro.bmj.com/content/9/1/e000959.full
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