Clinical Insights: breast cancer, rheumatoid arthritis and schizophrenia

Clinical insights take a look at some of the recent clinical research published across BioMed Central’s journals.

Exercise can reduce fatigue in breast cancer patients

Fatigue is a common and debilitating side effect of cancer treatment. There is some evidence that physical exercise during and after treatment can prevent and reduce cancer-related fatigue. Results of a new study suggest that starting a physical exercise program early during breast cancer therapy has beneficial effects on physical fatigue, cardiorespiratory fitness, and muscle strength.

The effects of an 18-week aerobic and resistance exercise intervention during chemotherapy were investigated in a randomized clinical trial. 204 patients with breast cancer were randomized to the intervention or usual care group, and were followed up at 18 and 36 weeks post-treatment. The exercise program was offered in routine clinical practice and started with 6 week from diagnosis.

Although both groups reported increased fatigue post-chemotherapy, physical fatigue was significantly lower in the exercise group compared to control. At 36 weeks, fatigue and fitness levels in both groups had returned to baseline levels. The exercise intervention did not significantly affect quality of life, anxiety, or depression.

Travier et al., BMC Medicine

Higher dose of folic acid does not reduce Methotrexate toxicity

Methotrexate (MTX) is used in the treatment of rheumatoid arthritis (RA) but, due to its toxicity, is often stopped. Folic acid can reduce this toxicity, but it is not clear whether increasing the dose of folic acid further reduces toxicity. New research suggests that this is not the case, and that increasing folic acid supplementation offers no additional benefits.

The researchers conducted a double-blind parallel-group randomized controlled trial involving 100 patients with rheumatoid arthritis to compare two doses of folic acid, 10 mg/week or 30 mg/week, alongside MTX treatment. The primary outcome was the occurrence of MTX toxicity during treatment and change in disease activity at 24 weeks.

Frequency of adverse effects due to MTX treatment was similar in both groups and at 24 weeks, there was no significant difference in good or moderate response to the treatment between the groups.

Dhir et al. Arthritis Research & Therapy

Motivational interviewing may help medical adherence in schizophrenia

Antipsychotics used in the treatment of schizophrenia and related disorders can have adverse effects, often leading to poor medication adherence and long term outcomes. A new study suggests that a motivational interviewing-based adherence therapy can improve medication adherence as well as having beneficial effects on other outcomes.

In a single-blind, randomized controlled trial, researchers investigated effectiveness of a motivational interviewing-based adherence therapy for outpatients with schizophrenia spectrum disorders. 114 participants were randomly assigned to either an eight-session course of adherence therapy plus usual care or usual care.

Over the six month follow up period, patients in the intervention group had reduced symptom severity and re-hospitalizations as well as improved medication adherence, functioning, and insight into their illness and treatment compared with those receiving usual care.

Chien et al., Trials

 

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