Physiology and Structure of the Small Airways in Patients With Chronic Airflow Obstruction or COVID-19 (PASSPORT)

January 18, 2021 updated by: Imperial College London
The purpose of this research project is to study small airways physiological function in patients with chronic obstructive lung disease or COVID-19 and explore the relationship with in-vivo microanatomical small airway structure as measured by OCT. Correlating endobronchial assessment with multiple breath nitrogen washout and impulse oscillometry will allow the characterisation of the relationship between small airway structural findings and these validated investigations. A small volume lung wash, endobronchial brushings and the collection of a limited number of endobronchial cryobiopsy samples will be performed to better understand the endobronchial environment of the small airways through inflammatory studies. Following the completion of any such work, residual samples will be stored in a "bio-bank" to enable the completion of future work. Understanding the relationship with symptom-based quality of life scoring questionnaires and a functional assessment of exercise capacity will help elucidate the clinical impact of in-vivo small airways findings.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Unknown

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
42

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

16 years and older (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Subjects over the age of 16 with either chronic airflow obstruction or COVID-19

Description

Inclusion Criteria:

  1. Age 16 or over
  2. Scheduled for bronchoscopy as part of clinical care or research protocol
  3. No bleeding diathesis or therapeutic anticoagulation

  4. COPD:

    • FEV1/FVC ratio <70% or

Asthma:

  • Diagnosed by standard clinical methods
  • Post-bronchodilator FEV1 ≥60% predicted or COVID-19 infection or previous COVID-19 infection (confirmed as per local guidelines)

Exclusion Criteria:

  1. Unable to provide informed consent
  2. Exacerbation of obstructive airways disease or respiratory infection requiring systemic antibiotics or corticosteroids in the 6 weeks prior to enrolment unless suffering from COVID-19 infection and bronchoscopy is required for clinical reasons

  3. Contra-indications to performing lung function testing

    • Aortic aneurysm >6cm
    • Unstable cardiovascular disease (unstable angina, myocardial infarction or pulmonary embolism <4 weeks prior)
    • Severe aortic stenosis
    • Pneumothorax
    • Cerebral aneurysm
    • Thoracic or abdominal surgery <4 weeks prior

  4. Contra-indications to passing oesophageal balloons

    • Oesophageal ulceration or varices
    • Sinusitis, recent nasal surgery or epistaxis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Chronic Airflow obstruction / COVID-19
Patients with either chronic airflow obstruction of COVID-19

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Respiratory resistance at 5Hz - 20Hz (R5-R20) (kPa/l/s) related to airtrapping as determined by quantitative CT (Expiratory phase low attenuation area <856 HU (%LAA <856 HU)
Time Frame: Baseline, pre-procedure
Impulse Oscillometry
Baseline, pre-procedure

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Respiratory reactance at 5Hz: X5 (kPa/l/s)
Time Frame: Baseline, pre-procedure
Impulse Oscillometry
Baseline, pre-procedure
Reactance area: Ax (kPa/l/s)
Time Frame: Baseline, pre-procedure
Impulse Oscillometry
Baseline, pre-procedure
Functional residual capacity by MBNW: FRCgas (L)
Time Frame: Baseline, pre-procedure
Multiple Breath Nitrogen Washout
Baseline, pre-procedure
Lung clearance index: LCI
Time Frame: Baseline, pre-procedure
Multiple Breath Nitrogen Washout
Baseline, pre-procedure
Ventilation heterogeneity conducting airways: Scond (L/s)
Time Frame: Baseline, pre-procedure
Multiple Breath Nitrogen Washout
Baseline, pre-procedure
Ventilation heterogeneity acinar airways: Sacin (L/s)
Time Frame: Baseline, pre-procedure
Multiple Breath Nitrogen Washout
Baseline, pre-procedure
Forced expiratory volume in 1 second: FEV1 (L)
Time Frame: Baseline, pre-procedure
Spirometry
Baseline, pre-procedure
Forced vital capacity: FVC (L)
Time Frame: Baseline, pre-procedure
Spirometry
Baseline, pre-procedure
Total lung capacity: TLC (L)
Time Frame: Baseline, pre-procedure
Plethysmography
Baseline, pre-procedure
Residual volume: RV (L)
Time Frame: Baseline, pre-procedure
Plethysmography
Baseline, pre-procedure
Functional residual capacity by plethysmography: FRCpleth (L)
Time Frame: Baseline, pre-procedure
plethysmography
Baseline, pre-procedure
Airway mean luminal diameter (Dmean)
Time Frame: Baseline, during the procedure
Optical Coherence Tomography
Baseline, during the procedure
Airway inner lumen area (Ai)
Time Frame: Baseline, during the procedure
Optical Coherence Tomography
Baseline, during the procedure
Airway wall area (Aw), airway wall percentage (Aw%) as determined by [Aw/(Ai + Aw) × 100%]
Time Frame: Baseline, during the procedure
Optical Coherence Tomography
Baseline, during the procedure
Air trapping - expiratory phase low attenuation area <856 HU (%LAA <856 HU)
Time Frame: Baseline, pre-procedure
Quantitative CT
Baseline, pre-procedure
Modified MRC dyspnoea score
Time Frame: Baseline, pre-procedure
Patient reported outcome measure
Baseline, pre-procedure
St George's Respiratory Questionnaire Score
Time Frame: Baseline, pre-procedure
Patient reported outcome measure
Baseline, pre-procedure
Asthma-related Quality of Life Questionnaire (AQLQ) (if asthmatic)
Time Frame: Baseline, pre-procedure
Patient reported outcome measure
Baseline, pre-procedure
Asthma Control Questionnaire (ACQ) (if asthmatic)
Time Frame: Baseline, pre-procedure
Patient reported outcome measure
Baseline, pre-procedure
6-minute walk distance (m)
Time Frame: Baseline, pre-procedure
6-minute walk distance (m)
Baseline, pre-procedure

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Exploratory: Inflammatory and pathological studies of airways brush, wash and cryobiopsy samples
Time Frame: Baseline, during the procedure
Laboratory based scientific studies
Baseline, during the procedure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Imperial College London

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 23, 2019

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 22, 2021

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 2, 2022

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 2, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 18, 2021

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 20, 2021

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 20, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 18, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2021

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 18IC4688

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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