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RCT·rheumatology, cardiology, clinical trial, internal medicine, nutrition·PMC10184018

Remotely Supervised Weight Loss and Exercise Training to Improve Rheumatoid Arthritis Cardiovascular Risk: Rationale and Design of the Supervised Weight Loss Plus Exercise Training‚ÄêRheumatoid Arthritis Trial

ACR Open Rheumatology · 14 authors, 2 centres

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TL;DR

This paper outlines the rationale and protocol for the Supervised Weight Loss Plus Exercise Training-Rheumatoid Arthritis (SWET-RA) trial.

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This paper outlines the rationale and protocol for the Supervised Weight Loss Plus Exercise Training-Rheumatoid Arthritis (SWET-RA) trial. Participants will be randomized to either a usual care control arm or a remotely delivered SWET intervention. The SWET program combines a dietitian-led caloric restriction diet targeting 7% weight loss with structured aerobic (150 minutes/week) and resistance (twice weekly) exercise training, delivered via video conference, a YouTube channel, and mobile applications. The primary outcome is the metabolic syndrome Z score, a continuous measure of cardiometabolic risk. Limitations include the small sample size and the non-pharmacologic nature of the intervention, which precludes changes in some traditional risk factors within the study period.

STUDY TYPE

RCT

SPECIALTY

rheumatology

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100% · A

ORIGINAL PAPER

PMC10184018

Remotely Supervised Weight Loss and Exercise Training to Improve Rheumatoid Arthritis Cardiovascular Risk: Rationale and Design of the Supervised Weight Loss Plus Exercise Training‚ÄêRheumatoid Arthritis Trial

ACR Open Rheumatology

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ABSTRACT

Patients with rheumatoid arthritis (RA) remain at an increased risk for cardiovascular disease (CVD) and mortality. RA CVD results from a combination of traditional risk factors and RA‚Äêrelated systemic inflammation. One hypothetical means of improving overall RA CVD risk is through reduction of excess body weight and increased physical activity. Together, weight loss and physical activity can improve traditional cardiometabolic health through fat mass loss, while also improving skeletal muscle health. Additionally, disease‚Äêrelated CVD risk may improve as both fat mass loss and exercise reduce systemic inflammation. To explore this hypothesis, 26 older persons with RA and overweight/obesity will be randomized to 16‚Äâweeks of a usual care control arm or to a remotely Supervised Weight Loss Plus Exercise Training (SWET) program. A caloric restriction diet (targeting 7% weight loss) will occur via a dietitian‚Äêled intervention, with weekly weigh‚Äêins and group support sessions. Exercise training will consist of both aerobic training (150 minutes/week moderate‚Äêto‚Äêvigorous exercise) and resistance training (twice weekly). The SWET remote program will be delivered via a combination of video conference, the study YouTube channel, and study mobile applications. The primary cardiometabolic outcome is the metabolic syndrome Z score, calculated from blood pressure, waist circumference, high‚Äêdensity lipoprotein cholesterol, triglycerides, and glucose. RA‚Äêspecific CVD risk will be assessed with measures of systemic inflammation, disease activity, patient‚Äêreported outcomes, and immune cell function. The SWET‚ÄêRA trial will be the first to assess whether a remotely supervised, combined lifestyle intervention improves cardiometabolic health in an at‚Äêrisk population of older individuals with RA and overweight/obesity.

CITATION EXPORT

BrianJ. Andonian, Leanna M. Ross, Alyssa M. Zidek et al.. Remotely Supervised Weight Loss and Exercise Training to Improve Rheumatoid Arthritis Cardiovascular Risk: Rationale and Design of the Supervised Weight Loss Plus Exercise Training‚ÄêRheumatoid Arthritis Trial. ACR Open Rheumatology. (2023). https://doi.org/10.1002/acr2.11536

AUTHORS

14 · 2 CENTRES

BrianJ. Andonian, Leanna M. Ross, Alyssa M. Zidek, Liezl B. Fos, Lucy W. Piner, Johanna L. Johnson, Kelsey B. Belski, Julie D. Counts, Carl F. Pieper, Ilene C. Siegler, Connie W. Bales, Kathryn N. Porter Starr, William E. Kraus, Kim M. Huffman

1 Duke University School of Medicine Durham North Carolina
2 Duke University School of Medicine and Geriatric Research, Education, and Clinical Center, Durham VA Medical Center Durham North Carolina