Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS)

Pettersson, Henrik; Alexanderson, Helene; Poole, Janet L.; Varga, János; Regardt, Malin; Russell, Anne-Marie; Salam, Yasser; Jensen, Kelly; Mansour, Jennifer; Frech, Tracy; Feghali‐Bostwick, Carol; Varjú, Cecília; Baldwin, Nancy; Heenan, Matty; Fligelstone, Kim; Holmner, Monica; Lammi, Matthew R.; Scholand, Mary Beth; Shapiro, Lee; Volkmann, Elizabeth R.; Saketkoo, Lesley Ann

doi:10.1016/j.berh.2021.101695

Cited by 21 publications

(19 citation statements)

References 251 publications

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“…Exercise as an essential multi-modal disease-modifying medicine Physical function and activity are key predictors of HRQoL and survival. Available evidence on exercise strongly supports diverse and diffuse benefits of physical activity as a potential cornerstone to SSc management [88] (Table 15). Exercise reduces inflammation and increases circulation (and body heat), which address essential drivers of SSc symptoms, in addition to enhancing mobility through improving strength, stiffness, endurance and aerobic capacity.…”

Section: Important Non-pharmacological Therapeutic Considerationsmentioning

confidence: 98%

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc

Saketkoo

Frech

Varjú

et al. 2021

Best Practice & Research Clinical Rheumatology

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Section: Important Non-pharmacological Therapeutic Considerationsmentioning

confidence: 98%

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc

Saketkoo

Frech

Varjú

et al. 2021

Best Practice & Research Clinical Rheumatology

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“…Cardiopulmonary rehabilitation is feasible, safe, and effective regardless of severity of ILD [17 ▪ ,28 ▪ ,32 ▪ ,33–35,61,62,63 ▪ ]; and is the safest way for people who are deconditioned and limited by dyspnea to initiate and learn how to exercise and safely intensify exercise over time. Cardiopulmonary rehabilitation also provides key education on symptom reduction and self-management that improves capacity, exercise tolerance, mobility breathing, fatigue, and cough [32 ▪ ,33–35,64,65].…”

Section: Physical Activity and Exercise Across The Lifespanmentioning

confidence: 99%

Ageing with Interstitial lung disease: preserving health and well being

Saketkoo

Ndili

Patterson

et al. 2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewAgeing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer. Recent findingsILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body.

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“…(28). Exercise and physical training are areas that are gaining momentum as systemic nonpharmacological treatment in inflammatory diseases and should be leveraged more frequently in sarcoidosis (65)(66)(67)(68)(69). Physical training/exercise is arguably both a systemic treatment that can modulate inflammation and a nonpharmacological therapy that cultivates physical capacity through amplification of neuromuscular and vascular networks and other bio-mechanical pathways that reduce symptom burden regardless of sarcoidosis disease activity status (67,(69)(70)(71).…”

Section: Non-pharmacological Therapies and Palliation Of Symptomsmentioning

confidence: 99%

Sarcoidosis: Updates on therapeutic drug trials and novel treatment approaches

et al. 2022

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Sarcoidosis is a systemic granulomatous inflammatory disease of unknown etiology. It affects the lungs in over 90% of patients yet extra-pulmonary and multi-organ involvement is common. Spontaneous remission of disease occurs commonly, nonetheless, over 50% of patients will require treatment and up to 30% of patients will develop a chronic progressive non-remitting disease with marked pulmonary fibrosis leading to significant morbidity and death. Guidelines outlining an immunosuppressive treatment approach to sarcoidosis were recently published, however, the strength of evidence behind many of the guideline recommended drugs is weak. None of the drugs currently used for the treatment of sarcoidosis have been rigorously studied and prescription of these drugs is often based on off-label” indications informed by experience with other diseases. Indeed, only two medications [prednisone and repository corticotropin (RCI) injection] currently used in the treatment of sarcoidosis are approved by the United States Food and Drug Administration. This situation results in significant reimbursement challenges especially for the more advanced (and often more effective) drugs that are favored for severe and refractory forms of disease causing an over-reliance on corticosteroids known to be associated with significant dose and duration dependent toxicities. This past decade has seen a renewed interest in developing new drugs and exploring novel therapeutic pathways for the treatment of sarcoidosis. Several of these trials are active randomized controlled trials (RCTs) designed to recruit relatively large numbers of patients with a goal to determine the safety, efficacy, and tolerability of these new molecules and therapeutic approaches. While it is an exciting time, it is also necessary to exercise caution. Resources including research dollars and most importantly, patient populations available for trials are limited and thus necessitate that several of the challenges facing drug trials and drug development in sarcoidosis are addressed. This will ensure that currently available resources are judiciously utilized. Our paper reviews the ongoing and anticipated drug trials in sarcoidosis and addresses the challenges facing these and future trials. We also review several recently completed trials and draw lessons that should be applied in future.

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Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS)

Cited by 21 publications

References 251 publications

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc

Ageing with Interstitial lung disease: preserving health and well being

Sarcoidosis: Updates on therapeutic drug trials and novel treatment approaches

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