Pilot Study to Investigate Contemplative Intervention in Lupus Patients

University of Virginia30 enrolled

Overview

The study tests whether contemplative-based intervention can modify pathogenic processes in participants with Lupus. Techniques such as meditation, mindfulness and yoga may have an impact on the disease and may decrease psychological distress, increase self-regulation capabilities, and reduce pain. Additionally, incorporating patients' caregivers may strengthen their relationships and, thereby, improve their health and well-being.

The objective of this pilot study is to test the feasibility of an innovative contemplative-based and caregiver-inclusive intervention can modify pathogenic processes in systemic lupus erythematosus (SLE). Contemplative techniques such as meditation, mindfulness and yoga may have an impact on the disease burden and may decrease psychological distress, increase self-regulation capabilities, and reduce pain. Research also suggests that contemplative practices, such as an intensive mindfulness intervention, may have a direct effect on the underlying disease process itself by altering epigenetic control of gene expression, decreasing proinflammatory cytokine production and reestablishing immunologic homeostasis. It is also well documented that social relationships moderate physical health. Incorporating patients' caregivers may strengthen their relationships and thereby improve their health and well-being. It is anticipated that the successful outcome of the intervention described in this proposal will provide the basis for a new and effective contemplative-based and caregiver-inclusive therapy for SLE and other rheumatic diseases.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Lupus Erythematosus, Systemic

Interventions

Mindfulness Based Group SessionsBEHAVIORAL

In-person group intervention sessions conducted with a combination of meditation, group exercise (yoga), group discussions, deep breathing and other mindfulness based practices.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Males and females who have given written informed consent * 18 and older * Literate in English: able to read, understand, follow instructions, and complete the rating scales and questionnaires accurately * Have a clinical diagnosis of systemic lupus erythematosus * Must pass the initial MRI screening administered over the phone * Inclusion criteria for support person: must be able to attend sessions with SLE patient. Exclusion Criteria: * Significant previous mindfulness training and experience (e.g. MBSR course, daily meditation practice) * Any current Axis I DSM-IV-TR psychiatric disorder that, in the clinician's opinion, warrants treatment or would preclude safe participation in the protocol, including, but not limited to: psychosis, schizophrenia, dementia, schizotypal personality disorder, borderline personality disorder, bipolar disorder, primary diagnosis of eating disorder, or chronic suicidality or homicidality. * Have clinical evidence of significant unstable or uncontrolled acute or chronic diseases not related to SLE (i.e., diabetes, cardiovascular, pulmonary, hematologic, gastrointestinal, neurological, or infectious) which, in the opinion of the treating physician, could confound the results of the study or put the patients at undue risk * Chronic use of prescribed or recreational psychoactive drugs (self-reported) * Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 364 days prior to Baseline (self-reported) * Diagnosis of lupus for over 20 years * Too sick to meaningfully participate (e.g. hospitalized, flaring at the time of screening) * In order to participate in the MRI portion of the study, participants must pass the in-person MRI screening administered by the MRI technician before each MRI. If participants fail the in-person MRI screening, they will be excluded from the MRI portion of the study, but can still participate in the intervention and blood draw portions of the study.

Locations (1)

University of Virginia

Charlottesville, Virginia, United States

Outcomes

Primary Outcomes

Change from baseline in blood

Number of participants with abnormal lab values (Complete Blood Count, Chemistry Panel, Autoantibodies, Complement C3 \& C4, Cytokines)

Time frame: Baseline Assessment, within 2 weeks prior to intervention, within 2 weeks after intervention

Secondary Outcomes

Change from baseline in brain activity during functional MRI

Number of participants with change in brain activity during functional MRI tasks (Handholding, Balloon Analog Risk Task, Penn Emotion Recognition Task, Operation Span Task, Resting State Task)

Time frame: Baseline Assessment, within 2 weeks prior to intervention, within 2 weeks after intervention

Change from baseline in Patient Reported Outcomes

Patient-reported change in health and symptoms

Time frame: Baseline Assessment, within 2 weeks prior to intervention, throughout the 6-week intervention, within 2 weeks after intervention

Change from baseline in SLE disease activity

Systemic Lupus Activity Questionnaire (SLAQ)

Time frame: Baseline Assessment, within 2 weeks prior to intervention, within 2 weeks after intervention

Change from baseline in psychosocial function

Self reported psychosocial function

Time frame: Baseline Assessment, within 2 weeks prior to intervention, throughout the 6-week intervention, within 2 weeks after intervention

Change from baseline in Heart Rate Variability

Collected using emWave device

Time frame: Throughout the entire 6-week intervention

Data from ClinicalTrials.gov

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