Fitness, Body Composition, Physical Activity and Sleep Patterns in People With Cystic Fibrosis on Modulator Therapy. (Understand-CF)

University of Portsmouth

Status

Enrolling

Conditions

Cystic Fibrosis

Study type

Observational

Funder types

Other

Identifiers

NCT05857709

313567

Details and patient eligibility

About

Cystic fibrosis (CF) is the most common inherited condition in the United Kingdom, affecting approximately 10,837 people. It is well recognised that regular exercise is clinically important for people with CF. Exercise function measured by the maximal oxygen consumption during a cardiopulmonary exercise test is often reduced in people with CF and this has been attributed to multiple factors including, altered heart and blood vessel function, muscle function, reduced physical activity levels and poorer sleep quality.

New medicine (modulators) have become available for many people with CF. Modulators appear able to reduce sweat chloride concentrations, improve lung function and reduce the frequency of pulmonary exacerbations in people with CF. Little evidence exists to show how they may have changed the fitness and underlying mechanisms responsible for this in people with CF.

This study aims to:

determine the exercise function
determine the blood vessel function
determine body composition
determine physical activity and sleep levels in people with CF on modulator therapy compared to a healthy controls group.

Full description

CF is the most common inherited condition in the United Kingdom, affecting approximately 10,837 people. CF affects the movement of salt and water across the body which leads to a thick sticky build up of mucus causing problems in the lungs and digestive system. CF also causes problems in other parts of the body for example, the heart, the blood vessels and muscles. This can impact a person with CFs' ability to exercise which can have impact prognosis, quality of life and increase the amount of times someone with CF is admitted to hospital due to a chest infection.

For many people with CF, new medicine (modulators) have lately become accessible bringing big changes to their health. Elexacaftor-tezacaftor-ivacaftor (ETI) is the most recently approved modulator for use in people with specific CF transmembrane conductance regulator gene mutations and is now the most widely used modulator therapy. So far clinical trials have largely looked at lung function, sweat chloride levels and body mass index. The wider reaching effects of modulator therapy on exercise function has not been studied. This study will see if people with CF have blood vessel and exercise dysfunction, abnormal body composition and reduced physical activity and sleep quality when they are taking modulator therapy compared to a healthy group.

The aims of this study are:

Determine the aerobic exercise function and mechanisms underlying this in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls;
Determine the peripheral muscle function in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls;
Determine the functional exercise capacity in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls;
Determine the micro- and macrovascular endothelial function in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls;
Determine body composition in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls;
Determine the physical activity levels and sleep duration and quality in people with CF stable on ETI and whether this is different to healthy age- and sex-matched controls

This study will recruit 50 people with CF and 50 healthy age- and sex-matched control participants who are older than 10 years of age. It will ask them to attend the University of Portsmouth for 2 visits. The first visit will last ~3 hours. During this time they will undergo measures on blood vessel function and aerobic exercise function. The second visit will last ~2 hours. During this time they will undergo a body composition scan and a series of muscle function test. At home, participants will wear an accelerometer for 7 days and complete a series of questionnaires.

Enrollment

100 estimated patients

Sex

All

Ages

10+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria for participants with cystic fibrosis:

Stable on the modulator therapy, Kaftrio®
Males and females ≥ 10 years of age
CF diagnosis based on clinical features, supported by a history of an abnormal sweat test (sweat chloride > 60 mmol·L-1 > 100 mg sweat), where possible, diagnostic genotyping would also be desired
Can clearly state that they are not pregnant
No contraindications to performing exercise
Can understand and cooperate with the study protocol
No increase in symptoms or weight loss in the preceding 2 weeks

Inclusion criteria for healthy control participants:

Healthy males and females who are age- and sex-matched to the enrolled individuals with CF
Can clearly state that they are not pregnant
No clinical diagnosis of a chronic disease
Can understand and cooperate with the study protocol
No contraindications to performing exhaustive exercise

Exclusion criteria for participants with cystic fibrosis:

Any non-pulmonary conditions that may impair exercise ability, such as musculoskeletal disorders and cardiovascular disease.
Unstable co-morbid asthma (daily pulmonary function variability of >20%)
Is pregnant during the initial screening process
Unable to understand or cooperate with the study protocol due to learning difficulties or otherwise
Not of a suitable age for testing
Is a smoker or inhales any other substances
Are taking vasoactive medications

Exclusion criteria for healthy control participants:

Any pulmonary, metabolic or cardiovascular conditions
Any other diagnosed disease
Any non-pulmonary conditions that may impair exercise ability, such as musculoskeletal disorders and cardiovascular disease
Is pregnant during the initial screening procedure
Presents with co-morbidities to performing exhaustive exercise
Is a smoker or inhales any other substance
Unable to understand or cooperate with the study protocol due to learning difficulties or otherwise
Not an age- or sex-match for the CF group
Are taking vasoactive medications