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An exercise program for men prescribed leuprorelin acetate, developed by the company that makes the drug, was effective in preventing weight gain, lowering blood pressure, and improving physical function, according to a study in

Robert Newton, PhD, DSc, of the Exercise Medicine Research Institute at Edith Cowan University in Joondalup, Western Australia, and colleagues analyzed data on 760 men who participated in the program, called , from 2014 to 2020. Developed by AbbVie, the program included weekly or twice-weekly supervised group aerobic and resistance-training exercise sessions.

Since androgen-deprivation therapy (ADT) such as leuprorelin has been associated with adverse events, the hope is that exercise might help counter the effects, the researchers explained. "Overweight and obesity are a common treatment-related adverse effect of ADT, and post-diagnosis weight gain has been associated with increased all-cause mortality and poorer prostate-specific outcomes."

The men in the program maintained their body weight (-0.1 kg, 95% CI -0.3 to 0.1, P=0.331) and experienced a small but significant reduction in waist circumference (-0.9 cm, 95% CI -1.2 to -0.5, P<0.001). There were also reductions in systolic blood pressure (-3.7 mmHg, 95% CI -4.8 to -2.6, P<0.001) and diastolic blood pressure (-1.7 mmHg, 95% CI -2.3 to -1.0, P<0.001) as well as significant improvements in cardiovascular fitness and muscle strength, the team reported.

"Moreover, patients presenting with the poorest outcome measures at baseline benefited the most from participating in the structured and supervised exercise sessions," the researchers wrote.

In the following interview, Newton, who is professor of Exercise Medicine and deputy director of the Exercise Medicine Research Institute, discussed the implications and additional details of the study.

What are your recommendations based on the results of the study?

Newton: All men already under treatment or commencing ADT as prostate cancer treatment should initiate a targeted exercise program immediately. This is particularly important if the patient is not already regularly exercising, as the side effects of ADT will only exacerbate the health consequences of being sedentary. The exercise should encompass both cardiorespiratory and resistance exercise training with the emphasis on targeting priority health issues.

What did patients self-report about their response to this exercise program?

Newton: Patients reported that they felt much more healthy and confident with improved physical function as a result of the exercise program. They enjoyed the exercise and felt that they were doing something positive to improve their health and fitness.

You noted that the study may have been affected by selection bias, or possibly even positive outcome bias. Can you explain this?

Newton: It is likely that patients who choose to participate in programs such as the ManPlan already have a quite positive attitude towards exercise, and so this may bias the outcomes in particular in terms of compliance and adherence to the exercise program long-term. Because of this self-selection into an exercise program there may be more positive outcomes as a result.

While the ManPlan has clearly had quite positive benefits for the participants, it is also critical that urologists and oncologists encourage all their patients to be more physically active, and in particular those who are resistant to exercise and physical activity.

The Man Plan program was created by AbbVie for men prescribed the company's product, leuprorelin acetate. Do other companies that make ADT drugs have exercise programs as well?

Newton: I am not aware of any other exercise medicine programs implemented by other companies supplying ADT drugs. All ADT drugs have these side effects, and the ManPlan is a very positive step by AbbVie to improve outcomes for patients and urologists by addressing these issues through exercise medicine.

Is there anything else you want to make sure oncologists understand about this study or its implications?

Newton: While ADT is very effective for controlling prostate cancer progression, there are toxicities which can result in considerable morbidity and mortality. Exercise medicine has been demonstrated to alleviate these side effects while also having additional benefits for reducing the risk of other chronic diseases, maintaining physical structure and function, and potentially increasing survival.

Read the study here.