TBA (26S141)

Structured exercise augments the frailty benefits of Altra9 for patients with advanced chronic liver disease

Author(s)

Matthew McKenna-Barry, Reza Saeidi, Ciara O’Connor, Noel McCaffrey, John Ryan, Karen Boland

Department(s)/Institutions

Royal College of Surgeons in Ireland Beaumont Hospital

Introduction

Frailty and sarcopenia increase the risk of death, decompensation and hospitalisation for patients with advanced chronic liver disease (ACLD). Effective therapies are required to mitigate these syndromes.

Aims/Background

Assess the impact of a combination structured exercise programme and branched chain amino acid supplementation for patients with ACLD.

Method

Patients with ACLD were recruited to a single centre intervention of a 12 week community based structured exercise programme (ExWell Medical, Dublin) twice weekly and once daily 30g Altra9 (Ajinomoto, Limerick). Patients were compared to those undergoing standard of care (SOC) and those undergoing once daily 30g Altra9 alone. Liver Frailty Index (LFI) was measured at induction, 3 weeks and 12 weeks.

Results

122 patients were recruited. 26 patients (17 week 3 and 10 week 12 results available) were assigned to combination, 48 (33 week 3 and 40 week 12 results available) to SOC and 48 (35 week 3 and 37 week 12 results available) to Altra9 alone. There were no statistically significant differences of gender, age, aetiology or MELD between groups Median change in LFI from induction to week 3 for the combination group was -0.42 (IQR -0.5 - -0.28), -0.23 (-0.45 - -0.10), p=0.036 for Altra9 alone and-0.17 (-0.32 – 0.11), p=0.002 for SOC. Median change in LFI from induction to week 12 for the combination group was -0.59 (IQR -0.77 - -0.36), -0.35 (-0.5 - -0.11), p=0.029 for Altra9 alone and -0.11 (-0.40 – 0.2), p=0.003 for SOC.

Conclusions

Combined structured exercise and once daily Altra9 resulted in a significant improvement in frailty for patients with ACLD. This does not appear to be mediated by increased muscle mass which did not see an improvement.