A Digital Exercise Intervention in Patients With Spondyloarthritis

NCT ID: NCT06462937

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

260 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-01

Study Completion Date

2030-08-01

Brief Summary

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This protocol describes a 6-month randomised, controlled exercise trial in patients with axial spondyloarthritis (axSpA) with re-randomization after 3-months. The primary outcome of the trial (disease activity) will be evaluated at 3-months. The exercise programme on trial comprises high intensity interval training (HIIT), muscular strength exercise and aerobic physical activity sessions of specified duration, frequency, and intensity. It also includes brief knowledge videos to empower the patient. The intervention is remotely delivered by the SPARK application with personalised follow-up including monitoring to ensure exercise progression and adherence to exercise intensity. The SPARK application is built on a platform delivered by ABEL Technologies (trademark) and is customised for patients with axSpA.

Detailed Description

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Main objectives: To assess if a digital personally tailored exercise program with remote follow-up can reduce disease activity measured by ankylosing spondylitis disease activity score (ASDAS) in patients with recently diagnosed axial spondyloarthritis (axSpA).

Main inclusion criteria Adults (\> 18 years) with clinical diagnosis from a rheumatologist of axSpA within the last 2 years of inclusion also fulfilling the ankylosing spondylitis disease activity score (ASAS) classification criteria, who are biologic disease modifying anti-rheumatic drugs (bDMARD) naïve, and have an active disease (ASDAS ≥ 1.3)

Main exclusion criteria:

Active iridocyclitis, c-reactive protein (CRP) \> 30, contraindication to high intensity interval training

Primary outcome Proportion of participants in ASDAS inactive (ASDAS \< 1.3) at 3 months

Number of participants: 260 (with an anticipated drop-out rate of 15%)

Study design: A two-arm multi-centre, clinical trial, randomization 1:1 to either digital exercise intervention with remote follow-up or usual care.

Intervention: Exercise delivered through an application and with personalised follow-up by a coach through remote sessions (the participant and SPARK-coach are not at the same physical location) weekly. The exercise is progressively tailored to the fitness level of each participant. The program consists of 5 session per week on 3 different days including: two sessions with HIIT, 2 sessions with strength exercise, and one session with an aerobic exercise at moderate intensity. Goal for HIIT is 10 minutes two times per week at 85-95% of maximal heart rate (20 minutes in total). The exercise will be performed at a location of the participants' choice and data will be logged by a sports watch.

Efficacy assessments: ASDAS disease activity measure (4 patient reported questions and measure of CRP), Bath ankylosing spondylitis disease activity index (BASDAI).

Physical measure: cardiorespiratory fitness, in a subset of participants direct cardiopulmonary testing, muscular strength tests.

Psychological measures: Warwick and Edinburgh mental wellbeing scale (WEMWBS), EuroQol (EQ5D).

Medication: use of bDMARDs, use of NSAID

Safety assessments General physical examination and vital signs, laboratory tests as a part of usual clinical care, record of adverse events and serious adverse events, magnetic resonance imaging (MRI).

Conditions

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Spondyloarthritis Exercise

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Baseline: randomization to intervention (Exercise) or control (Usual care) 1:1.

3 months: randomization to intervention (Exercise remotely delivered plan with personalised weekly follow-up) or control (Exercise remotely delivered plan without weekly follow-up)
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors
The randomization is performed by a study personnel not involved in data collection. Patients are asked not to inform their care-giver or the physiotherapist who perform the study tests which group the patient is allocated to.

Study Groups

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Exercise with personal supervision 0-3 months

Exercise

Group Type EXPERIMENTAL

Exercise with supervision

Intervention Type BEHAVIORAL

Remote exercise will be administered with digital supervision. The Exercise group will receive a personalised program with individual adaptations aiming to perform 3 exercise sessions per week including HIIT, strength exercise and moderate intensive aerobic exercise. Participants will consult their rheumatologist parallel to the SPARK trial.

Control 0-3 months

Usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

Exercise with personal supervision 3-6 months

Exercise

Group Type EXPERIMENTAL

Exercise with supervision

Intervention Type BEHAVIORAL

Remote exercise will be administered with digital supervision. The Exercise group will receive a personalised program with individual adaptations aiming to perform 3 exercise sessions per week including HIIT, strength exercise and moderate intensive aerobic exercise. Participants will consult their rheumatologist parallel to the SPARK trial.

Exercise without personal supervision 3-6 months

Exercise

Group Type ACTIVE_COMPARATOR

Exercise without supervision

Intervention Type BEHAVIORAL

Remote exercise will be administered without digital supervision. Participants will receive a standard exercise program fulfilling the exercise protocol requirements, the exercise program will progress. But there will be no direct contact between the participant and the coach. Participants will consult their rheumatologist parallel to the SPARK trial.

Interventions

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Exercise with supervision

Remote exercise will be administered with digital supervision. The Exercise group will receive a personalised program with individual adaptations aiming to perform 3 exercise sessions per week including HIIT, strength exercise and moderate intensive aerobic exercise. Participants will consult their rheumatologist parallel to the SPARK trial.

Intervention Type BEHAVIORAL

Exercise without supervision

Remote exercise will be administered without digital supervision. Participants will receive a standard exercise program fulfilling the exercise protocol requirements, the exercise program will progress. But there will be no direct contact between the participant and the coach. Participants will consult their rheumatologist parallel to the SPARK trial.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* axSpA diagnosis within the last two years by a rheumatologist according to the ASAS criteria of 2009
* active disease (ASDAS \> 1.3)

Exclusion Criteria

* Active uveitis.
* CRP \> 30.
* Former or current use of bDMARDs.
* Pregnancy or planned pregnancy within 6 months from inclusion.
* Absolute and relative contradictions to high intensity exercise according to the American College of Sports Medicine (ACSM)
* Other serious disease such as cancer.
* Patients incapable to follow the protocol or the control set-up with remote monitoring.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Diakonhjemmet Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Diakonhjemmet hospital

Oslo, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Sella A Provan, Professor

Role: CONTACT

4791582581

Birgitte Nellemann, PhD

Role: CONTACT

4747957020

Facility Contacts

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Birgitte Nellemann

Role: primary

4747957020

Other Identifiers

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DS00735

Identifier Type: -

Identifier Source: org_study_id

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