This study assessed the effect of 12-week aerobic exercise on arterial stiffness (primary outcome), inflammation, oxidative stress, and cardiorespiratory fitness (secondary outcomes) in women with systemic lupus erythematosus (SLE). In a non-randomized clinical trial, 58 women with SLE were assigned to either aerobic exercise (n = 26) or usual care (n = 32). The intervention comprised 12 weeks of aerobic exercise (2 sessions × 75 min/week) between 40–75% of the individual’s heart rate reserve. At baseline and at week 12, arterial stiffness was assessed through pulse wave velocity (PWV), inflammatory (i.e., high-sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TFN-α], and inteleukin 6 [IL-6]) and oxidative stress (i.e., myeloperoxidase [MPO]) markers were obtained from blood samples, and cardiorespiratory fitness was assessed (Bruce test). There were no between-group differences in the changes in arterial stiffness (median PWV difference −0.034, 95% CI −0.42 to 0.36 m/s; p = 0.860) or hsCRP, TNF-α, IL-6, and MPO (all p > 0.05) at week 12. In comparison to the control group, the exercise group significantly increased cardiorespiratory fitness (median difference 2.26 minutes, 95% CI 0.98 to 3.55; p = 0.001). These results suggest that 12 weeks of progressive treadmill aerobic exercise increases cardiorespiratory fitness without exacerbating arterial stiffness, inflammation, or oxidative stress in women with SLE.

The results of this study suggest that cardiorespiratory fitness might attenuate the age-related arterial stiffening in women with systemic lupus erythematosus and might thus contribute to the primary prevention of cardiovascular disease in this population. As the cross-sectional design precludes establishing causal relationships, future clinical trials should confirm or contrast these findings.

ObjectivesTo examine the association of objectively measured physical activity (PA) intensity levels and sedentary time with arterial stiffness in women with systemic lupus erythematosus (SLE) with mild disease activity and to analyze whether participants meeting the international PA guidelines have lower arterial stiffness than those not meeting the PA guidelines.MethodsThe study comprised 47 women with SLE (average age 41.2 [standard deviation 13.9]) years, with clinical and treatment stability during the 6 months prior to the study. PA intensity levels and sedentary time were objectively measured with triaxial accelerometry. Arterial stiffness was assessed through pulse wave velocity, evaluated by Mobil-O-Graph® 24h pulse wave analysis monitor.ResultsThe average time in moderate to vigorous PA in bouts of ≥10 consecutive minutes was 135.1±151.8 minutes per week. There was no association of PA intensity levels and sedentary time with arterial stiffness, either in crude analyses or after adjusting for potential confounders. Participants who met the international PA guidelines did not show lower pulse wave velocity than those not meeting them (b = -0.169; 95% CI: -0.480 to 0.143; P = 0.280).ConclusionsOur results suggest that PA intensity levels and sedentary time are not associated with arterial stiffness in patients with SLE. Further analyses revealed that patients with SLE meeting international PA guidelines did not present lower arterial stiffness than those not meeting the PA guidelines. Future prospective research is needed to better understand the association of PA and sedentary time with arterial stiffness in patients with SLE.

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Background:Despite the relevant advance in treatment options and survival rates in systemic lupus erythematosus (SLE), patient’s quality of life (QOL) and other patient-reported outcomes (PROs) do not seem to improve accordingly [1]. PROs provide valuable information about the patient’s perceptions across a variety of domains that should be considered in a successful management of this condition [2]. Exercise seems to be a safe way to improve cardiorespiratory fitness [3], and could have also a positive influence on PROs in SLE.Objectives:To evaluate the effects of 12-week aerobic exercise intervention on PROs (QOL, depression, stress, and fatigue) in women with SLE.Methods:These are secondary outcomes of a non-randomized clinical trial [NCT03107442]. A total of 58 participants with SLE were assigned to exercise group (n=26) or control group (n=32). The exercise intervention followed the American College of Sports Medicine guidelines, and consisted of 12-week progressive aerobic exercise on a treadmill (2 sessions/week) between 40%-75% of the individual’s heart rate reserve [3]. Attendance of ≥75% was set for inclusion in the analyses. The control group received verbal information about a healthy lifestyle. At baseline, and at week 12, PROs were assessed including the physical and mental summary scores of the 36-item Short-Form Health Survey (SF-36), depression (Beck Depression Inventory; BDI-II), perceived stress (visual analogue scale) and fatigue (Multidimensional Fatigue Inventory; MFI-20). A total of 49 women with SLE (age: 44.5±14.2 years) completed all the assessments (exercise=21; control=28) and were included in the per-protocol (primary) analyses. The exercise and control group were comparable in age, disease duration and SLE activity, sociodemographic characteristics, and BMI at baseline, although there were differences in BDI-II scores. Baseline values and BDI-II values were used as covariates in the analyses.Results:In comparison to the control group, the exercise group showed a significant reduction in general fatigue (mean difference -2.11 units; 95% CI -4.18 to -0.04; P=0.046) and physical fatigue (mean difference -3.90 units; 95% CI -6.3 to -1.5; P= 0.002) following the intervention. There were no between-group differences in the changes from baseline to week 12 either in physical (P=0.828) or mental (P=0.767) QOL, depression (P=0.498), perceived stress (P=0.247) or other fatigue dimensions (mental, reduced motivation, reduced activity, all P>0.05).Conclusion:The results of this study suggest that 12 weeks of progressive aerobic exercise might improve relevant dimensions of fatigue in women with SLE, despite absence of effects on QOL, depression or perceived stress.References:[1] Mcelhone K, Abbott J, Teh L-S. A review of health related quality of life in systemic lupus erythematosus. Lupus. 2006;15: 633–643.[2] Mahieu M, Yount S, Ramsey-Goldman R. Patient-reported outcomes in systemic lupus erythematosus. Rheum Dis Clin. Elsevier; 2016;42: 253–263.[3] Soriano-maldonado A, Morillas-de-laguno P, Sa...