TY - JOUR

T1 - Effect of high-intensity interval training on inhaled corticosteroid dose in asthma patients: A randomized controlled trial

AU - Pitzner-Fabricius, Anders

AU - Dall, Christian H

AU - Henriksen, Marius

AU - Hansen, Erik S H

AU - Tønnesen, Louise L

AU - Hostrup, Morten

AU - Backer, Vibeke

N1 - Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2023

Y1 - 2023

N2 - Background: Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, ICS has side effects, and dose reduction is recommended when possible. Physical exercise improves asthma control, but it is unknown whether it reduces the reliance on ICS.Objective: To assess whether supervised high-intensity interval training reduces the need for ICS in untrained asthma patients.Methods: An assessor-blinded single-center randomized controlled trial, Copenhagen, Denmark. One hundred fifty untrained ICS-treated adults with symptomatic asthma were randomly assigned (2:1) to 6 months of supervised exercise 3 times weekly or a lifestyle as usual control group. Every second month, a clinical algorithm based on symptom control was applied in both groups to adjust ICS dose. Primary outcome was the proportion who had their ICS dose reduced by 25% or more after 6 months. Secondary outcomes included actual ICS dosage in micrograms per day.Results: Between October 2017 and December 2019, 102 patients were allocated to exercise intervention (86% completed) and 48 to the control (85% completed). At the 6-month visit, 63% versus 50% met the primary outcome in the exercise and control groups, respectively (adjusted risk difference 9.6% [95% CI -3.8 to 18.8]; P = .15). Daily ICS dose was reduced in favor of the exercise group, with a mean difference of -234 μg (95% CI -391 to -77; P = .0037), corresponding to a 24% reduction from baseline. This effect was sustained at 12 months. The intervention was safe and well tolerated.Conclusions: Six months of regular exercise results in reduction in daily ICS dose without compromising asthma control.

AB - Background: Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, ICS has side effects, and dose reduction is recommended when possible. Physical exercise improves asthma control, but it is unknown whether it reduces the reliance on ICS.Objective: To assess whether supervised high-intensity interval training reduces the need for ICS in untrained asthma patients.Methods: An assessor-blinded single-center randomized controlled trial, Copenhagen, Denmark. One hundred fifty untrained ICS-treated adults with symptomatic asthma were randomly assigned (2:1) to 6 months of supervised exercise 3 times weekly or a lifestyle as usual control group. Every second month, a clinical algorithm based on symptom control was applied in both groups to adjust ICS dose. Primary outcome was the proportion who had their ICS dose reduced by 25% or more after 6 months. Secondary outcomes included actual ICS dosage in micrograms per day.Results: Between October 2017 and December 2019, 102 patients were allocated to exercise intervention (86% completed) and 48 to the control (85% completed). At the 6-month visit, 63% versus 50% met the primary outcome in the exercise and control groups, respectively (adjusted risk difference 9.6% [95% CI -3.8 to 18.8]; P = .15). Daily ICS dose was reduced in favor of the exercise group, with a mean difference of -234 μg (95% CI -391 to -77; P = .0037), corresponding to a 24% reduction from baseline. This effect was sustained at 12 months. The intervention was safe and well tolerated.Conclusions: Six months of regular exercise results in reduction in daily ICS dose without compromising asthma control.

KW - Faculty of Science

KW - Asthma

KW - Inhaled corticosteroids

KW - Step-down

KW - Corticosteroid-sparing

KW - High-intensity interval training (HIIT)

KW - Exercise

KW - Behavioral intervention

KW - Nonpharmacological

U2 - 10.1016/j.jaip.2023.04.013

DO - 10.1016/j.jaip.2023.04.013

M3 - Journal article

C2 - 37256238

VL - 11

SP - 2133-2143.e8

JO - The Journal of Allergy and Clinical Immunology: In Practice

JF - The Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

IS - 7

ER -