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Late-Onset AsthmaATOMNCT03747211

Asthma Severity in Women: The Influence of Training and Menopause

A study testing Aerobic exercise in people with Late-Onset Asthma, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Introduction: Late-onset asthma in women is characterized by poor disease control and reduced quality of life despite intensive treatment with inhaled steroid and beta2-agonist. The condition is further worsened at menopause due to the loss of estrogen leading to increased asthma exacerbation frequency, increased… Read more about this study

Who is it for?
Ages 45 to 75 years, women only
Conditions the study is for
Late-Onset Asthma
What is being tested?
Aerobic exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteDenmark
Study dates
12 Feb 2019to 1 May 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 to 75 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Late onset asthma (Debut ≥ 16 years of age)
  • ACQ ≥ 1.25
  • Daily treatment for asthma (GINA 2 and above)
  • Age 45 - 75
  • Postmenopausal defined as no menstruation for 6 months, Serum Follicle stimulating hormone >20 International Units per Liter and P-Estradiol nmol/L <0.09
  • BMI 25 - 35
Show all 9Show fewer
  • Positive bronchial challenge to methacholine, mannitol or positive reversibility to beta2-agonist now or historically
  • Untrained (no participation in vigorous exercise for more than 1 hour per week during the last 2 months)
  • Capable of exercising on a bike

Who cannot join

  • Unable to speak and understand Danish or English.
  • Current or former smokers (>6 months cessation) with >20 years of daily smoking with 20 cigarettes per day.
  • Other respiratory disease of clinical significance
  • Cardiovascular: Unstable ischemic heart disease, myocardial infarction within the last 12 months, symptomatic heart failure (EF <40%), symptomatic heart arrhythmia (documented with ECG), uncontrolled hypertension (>155/100)
  • Any disorder that is not stable and in the opinion of the investigator could affect the safety of the subject throughout the study
  • Subjects, who by investigators determination, will not be able to adhere to study protocol

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Respiratory research unit, Bispebjerg University Hospital

    Copenhagen, 2400

Other trials in Denmark

About this study

Official title: The ATOM Study: Asthma Severity in Women: The Influence of Training and Menopause

Introduction: Late-onset asthma in women is characterized by poor disease control and reduced quality of life despite intensive treatment with inhaled steroid and beta2-agonist. The condition is further worsened at menopause due to the loss of estrogen leading to increased asthma exacerbation frequency, increased airway inflammation and decreased lung function. Exercise training may increase disease control of asthma patients, but to what extent the same effect is seen in postmenopausal women with late-onset asthma is unknown. These asthma patients represent a phenotype that is characterized by low eosinophilic airway inflammation, severe symptoms, moderate obesity and poor response to conventional medicine. Thus, our hypothesis is that regular physical exercise is especially associated with an improvement in asthma control in this phenotype. The aim of this project is to test this hypothesis and to assess whether an improvement is associated with reduced local and systemic inflammation, change in heart function, lung function and/or body composition.

Study design: 40 postmenopausal women with late-onset asthma are recruited via the outpatient clinic at the Respiratory Department at Bispebjerg Hospital and through advertisement. The participants are randomized 1:1 into two groups. One group performs supervised exercise training (spinning) three times per week for 12 weeks while the other group is a control group. Before and after the intervention asthma control, local and systemic inflammation, heart function and body composition is measured.

Read more

Results: Analysis will be performed to detect changes within and between the groups before and after intervention. Primary outcome is change in ACQ (Asthma Control Questionnaire). Local and systemic inflammation is measured by changes in bronchial challenge to methacholine, sputum cell count and blood tests. Furthermore, secondary outcomes include change in heart function measured by stress-echocardiography and change in body composition measured by Dual-energy X-ray absorptiometry (DEXA).

Conclusion: There are to date no prospective studies that can support recommendations containing asthma rehabilitation with supervised regular physical activity for postmenopausal women. Thus, this study will provide novel understanding of the importance of physical activity in a chronic disease such as asthma.

Read the detailed description

Overall study design

The study is a single-blinded randomized controlled intervention study. Forty postmenopausal women with late-onset asthma (>16 years at debut) are recruited from the asthma outpatient-clinic at Bispebjerg Hospital or other hospital/practitioner in the region and/or by advertisement. The participants are block-randomized into two groups of 20, where one group is control and the other undergoes a period of regular exercise training. The investigators will be blinded and will not know whether the subjects have trained or not.

Detailed study design

Participants allocated to the exercise training group undergo a training intervention consisting of 45 minutes of intermittent high intensity aerobic spinning training three times per week for 12 weeks. Participants allocated to the control group will continue usual care without training. No changes to current treatment will be made by the investigators on any of the groups.

The training will consist of short periods of high intensity intervals where subjects reach above 80% of maximal oxygen consumption. Spinning sessions will be fully supervised by trained instructors with a bachelor of sports and science or bachelor of medicine and conducted in the Department of Nutrition, Exercise and Sports, University of Copenhagen. Subjects will wear heart rate monitors to ensure adherence to the training protocol. Within two weeks, before and after the intervention, participants from both groups undergo 3 days of testing.

To ensure equal compliance with asthma medication both groups will receive daily electronic reminders. Once a week, all participants will be asked about their compliance to their medication.

Being tested
Aerobic exercise

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT03747211
Study groupRoleWhat they receive
Aerobic exercise interventionExperimentalAerobic exercise by high intensity interval training, 3 times per week for 12 weeks
Receives: Behavioral: Aerobic exercise
Control groupNo interventionNo intervention for 12 weeks

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Asthma control - Asthma Control Questionnaire (ACQ)

    Changes in Asthma Control Questionnaire (ACQ) 7-point scale (0=no impairment, 6= maximum impairment for symptoms and rescue use)

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

Secondary outcomes (32)
  1. Heart Rate Variability

    Changes in:

    • Heart rate variability

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  2. Heart rhytm

    Changes in:

    • Heart rhythm

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  3. Heart Rate

    Changes in:

    • electrocardiography

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  4. Heart function - Strain

    Measured by stress-echocardiography

    • Strain

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  5. Heart function - Ejection fraction

    Measured by stress-echocardiography

    • Ejection fraction

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  6. Heart function - Tricuspid annular plane systolic excursion

    Measured by stress-echocardiography

    • Tricuspid annular plane systolic excursion

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  7. Heart function - Right ventricular function

    Measured by stress-echocardiography

    • Right ventricular function

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  8. Heart function - Pulmonary pressure

    Measured by stress-echocardiography

    • Pulmonary pressure

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  9. Heart function - Lung covered cor

    Measured by stress-echocardiography

    • Lung covered cor

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  10. Heart function - Blood pressure

    Blood pressure

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  11. Heart function - Cardiac output

    Cardiac output

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  12. Heart function - Stroke volume

    Stroke volume

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  13. Heart function - Total peripheral resistance

    Total peripheral resistance

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  14. Systemic inflammation - Leukocytes + differential cell count count

    Changes in

    • Leukocytes + differential cell count count

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  15. Systemic inflammation - Interleukin 6

    Changes in

    • Interleukin 6

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  16. Systemic inflammation - Interleukin 8

    Changes in

    • Interleukin 8

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  17. Systemic inflammation

    Changes in

    • Other interleukins

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  18. Systemic inflammation - Tumor Necrosis Factor alpha

    Changes in

    • Tumor Necrosis Factor alpha

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  19. Systemic inflammation - Total immunoglobulin E, Specific immunoglobulin E

    Changes in

    • Total immunoglobulin E
    • Specific immunoglobulin E

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  20. Systemic inflammation - high sensitivity c reactive protein

    Changes in

    • high sensitivity c reactive protein

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  21. Local airway inflammation - Sputum cell count

    Changes in

    • Sputum cell count

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  22. Local airway inflammation - Fraction of exhaled nitric oxide

    Changes in

    • Fraction of exhaled nitric oxide

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  23. Local airway inflammation - Hyperreactivity to inhaled methacholine

    Changes in

    • Hyperreactivity to inhaled methacholine

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  24. Body Composition

    Changes in

    • Total body fat

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  25. Body Composition

    Changes in

    • Lean body mass

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  26. Body Composition

    Changes in

    • Muscle mass

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  27. Body Composition

    Changes in

    • Weight

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  28. Microbiome

    Changes in the microbiota in sputum, oral cavity and nasal cavity before and after the training intervention

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  29. Compliance - Foster score

    Change in

    • Foster score Answers describe last weeks medicine use. Answers range form 0/7 - 7/7 with low values being worse.

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  30. Other asthma related questionnaires - Nijmegen questionnaire

    Changes in

    • Nijmegen questionnaire Values range from 0-64 and values below 20 are considered normal.

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  31. Other asthma related questionnaires - Mini Asthma Quality of Life Questionnaire (miniAQLQ)

    Changes in

    • Mini Asthma Quality of Life Questionnaire (miniAQLQ) 7-point Likert scale (7 = not impaired at all - 1 = severely impaired).

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

  32. Other asthma related questionnaires - Hospital Anxiety and Depression Scale (HADS) 2 items with 7 questions regarding anxiety and depression. (0 = no sign of depression/anxiety, 21 = maximal signs of anxiety/depression)

    Changes in

    • Hospital Anxiety and Depression Scale (HADS)

    Measured: -21 to 0 days before intervention and 0 to 14 days post intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Nov 2018
  2. Study start12 Feb 2019
  3. Primary completion1 May 2021
  4. Study completion1 May 2021

Why it stopped: Issues recruiting participants during COVID-19

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized, outcome assessor blinded, controlled trial
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03747211
Sponsor's protocol ID
ATOM
Acronym
ATOM
Status last verified
Jun 2021
First submitted
9 Nov 2018
Last updated
23 Jun 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data that support the results of this study will be made available immediately, with no end date, after deidentification and upon reasonable request.

Publications

  • Hansen ESH, Rasmusen HK, Hostrup M, Hellsten Y, Backer V. The effect of aerobic exercise training on asthma control in postmenopausal women (ATOM): a randomized controlled pilot study. Eur Clin Respir J. 2023 Sep 4;10(1):2251256. doi: 10.1080/20018525.2023.2251256. eCollection 2023.

    PubMed 37674777
  • Hansen ESH, Hostrup M, Rasmusen HK, Hellsten Y, Backer V. Effect of aerobic exercise training on asthma control in postmenopausal women (the ATOM-study): protocol for an outcome assessor, randomised controlled trial. BMJ Open. 2021 Apr 22;11(4):e049477. doi: 10.1136/bmjopen-2021-049477.

    PubMed 33888532

Questions about this trial

What is this clinical trial studying?

A study testing Aerobic exercise in people with Late-Onset Asthma, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 23 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Issues recruiting participants during COVID-19). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Asthma control - Asthma Control Questionnaire (ACQ) (time frame: -21 to 0 days before intervention and 0 to 14 days post intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03747211, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jun 2021.

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