1,720,973 research outputs found
Effect of Bimagrumab on body composition: a systematic review and meta-analysis
No full textAbstract Background Sarcopenia, a condition marked by progressive muscle mass and function decline, presents significant challenges in aging populations and those with chronic illnesses. Current standard treatments such as dietary interventions and exercise programs are often unsustainable. There is increasing interest in pharmacological interventions like bimagrumab, a monoclonal antibody that promotes muscle hypertrophy by inhibiting muscle atrophy ligands. Bimagrumab has shown effectiveness in various conditions, including sarcopenia. Aim The primary objective of this meta-analysis is to evaluate the impact of bimagrumab treatment on both physical performance and body composition among patients diagnosed with sarcopenia. Materials and methods This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed, Ovid/Medline, Web of Science, and the Cochrane Library databases up to June 2024 using appropriate Medical Subject Headings (MeSH) terms and keywords related to bimagrumab and sarcopenia. Eligible studies were randomized controlled trials (RCTs) that assessed the effects of bimagrumab on physical performance (e.g., muscle strength, gait speed, six-minute walk distance) and body composition (e.g., muscle volume, fat-free body mass, fat body mass) in patients with sarcopenia. Data extraction was independently performed by two reviewers using a standardized form, with discrepancies resolved through discussion or consultation with a third reviewer. Results From an initial search yielding 46 records, we screened titles, abstracts, and full texts to include seven RCTs in our meta-analysis. Bimagrumab treatment significantly increased thigh muscle volume (mean difference [MD] 5.29%, 95% confidence interval [CI] 4.08% to 6.50%, P < 0.001; moderate heterogeneity χ2 = 6.41, I2 = 38%, P = 0.17) and fat-free body mass (MD 1.90 kg, 95% CI 1.57 kg to 2.23 kg, P < 0.001; moderate heterogeneity χ2 = 8.60, I2 = 30%, P = 0.20), while decreasing fat body mass compared to placebo (MD − 4.55 kg, 95% CI − 5.08 kg to − 4.01 kg, P < 0.001; substantial heterogeneity χ2 = 27.44, I2 = 89%, P < 0.001). However, no significant improvement was observed in muscle strength or physical performance measures such as gait speed and six-minute walk distance with bimagrumab treatment, except among participants with slower baseline walking speeds or distances. Discussion and conclusion This meta-analysis provides valuable insights into the effects of bimagrumab on sarcopenic patients, highlighting its significant improvements in body composition parameters but limited impact on functional outcomes. The observed heterogeneity in outcomes across studies underscores the need for cautious interpretation, considering variations in study populations, treatment durations, and outcome assessments. While bimagrumab shows promise as a safe pharmacological intervention for enhancing muscle mass and reducing fat mass in sarcopenia, its minimal effects on muscle strength and broader physical performance suggest potential limitations in translating body composition improvements into functional gains. Further research is needed to clarify its long-term efficacy, optimal dosing regimens, and potential benefits for specific subgroups of sarcopenic patients.Open-Access-Publikationsfonds 202
Association of peripheral edema on body composition analysis in patients with heart failure
No full textFerric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial
No full textAbstract Background and Aims Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF). Methods FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100–299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL). Results The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5–93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07–0.96; P = .043) was lower with FCM than placebo. Conclusions In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort
Predictors of lower exercise capacity in patients with cancer
No full textAbstract Maintaining cancer patients’ exercise capacity and therefore patients’ ability to live a self-determined life is of huge importance, but little is known about major determinants. We sought to identify determinants of exercise capacity in patients with a broad spectrum of cancer types, who were already receiving cancer treatment or about to commence such therapy. Exercise capacity was assessed in 253 consecutive patients mostly suffering from advanced cancer using the 6-min walk test (6-MWT). All patients underwent echocardiography, physical examination, resting electrocardiogram, hand grip strength (HGS) measurement, and laboratory assessments. Patients were divided into two groups according to the median distance in the 6-MWT (459 m). Patients with lower exercise capacity were older, had significantly lower HGS and haemoglobin and higher values of high sensitive (hs) Troponin T and NT-proBNP (all p 0.2). Using multivariable logistic regression, we found that the presence of anaemia (odds ratio (OR) 6.172, 95% confidence interval (CI) 1.401–27.201, p = 0.016) as well as an increase in hs Troponin T (OR 3.077, 95% CI 1.202–5.301, p = 0.019) remained independent predictors of impaired exercise capacity. Increasing HGS was associated with a reduced risk of a lower exercise capacity (OR 0.896, 95% CI 0.813–0.987, p = 0.026). Screening patients for elevated hs troponin levels as well as reduced HGS may help to identify patients at risk of lower exercise capacity during cancer treatment.German Center for Cardiovascular Research 100010447Georg-August-Universität Göttingen 501100003385Open-Access-Publikationsfonds 202
Physical activity and its effects in myasthenia gravis: a patient-reported study on habits and impact
No full textAbstract Background Physical activity and exercise have been classified as safe and effective in mild to moderate cases of myasthenia gravis (MG) across various studies. Subsequently, adequate physical activity is generally recommended. Nevertheless, individuals with MG remain less physically active than the general population, without a precise definition of the low-activity group so far. Methods In this prospective single-center study, individuals with MG completed a questionnaire assessing general mobility, weekly physical activity levels, and beliefs toward specific statements about physical exercise. These data were contextualized with clinical parameters and MG-specific scores. Results Among 84 individuals (50% female), 73.8% reported general positive effects, and 77.4% noted improvements in mood and well-being due to physical activity. No significant differences in physical activity levels were found depending on sex, BMI or age. Weekly physical activity averaged 94.6 min (SD: 85.6), falling below current recommendations. Physical activity was inversely correlated with lower QMG ( p = 0.019) and MG-ADL scores ( p = 0.004). Despite the reported positive impact of physical activity on quality of life, no relevant connection was detected between physical activity and MG-QoL15 scores. Barriers preventing individuals affected by MG from engaging in physical activity included muscle pain (35.4%) and motivational challenges (22%). Individuals with motivational problems were younger (mean age 55.5 vs. 66.6 years, p = 0.011) and more frequently reported depressive symptoms; no other significant differences were observed in gender or disease severity in this subgroup. Conclusion Individuals with MG perceive physical activity as beneficial to their physical well-being, mood, and overall quality of life. Those with less severe disease tend to be more active. However, barriers such as motivational issues and post-exercise pain must be addressed. Clinicians should aim to identify individuals with low activity levels, encourage engagement in physical activity, highlight its benefits, and alleviate patient concerns. Trial registration Study approval by the Ethics Committee of the University Medical Center Göttingen was granted (number 33/12/21). The study was retrospectively registered at the German Clinical Trial Registry (DRKS) under the study ID DRKS00033171 (Date of trial registration December 1st, 2023)
Diabetes mellitus is associated with low exercise capacity and impaired peripheral vasodilation in patients with heart failure − a propensity score-matched study
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