Effect of Ipratropium Bromide on EILO
The Effect of Ipratropium Bromide on Exercise-Induced Laryngeal Obstruction (EILO) in Pediatric Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Many children and adolescents struggle with breathing problems during exercise. These symptoms can lead them to underperform, quit sports, and in some cases, stop being active altogether. One under-recognized cause is Exercise-Induced Laryngeal Obstruction (EILO), a narrowing of the airway at the level of the voice box. Approximately 5-8% of adolescents and 20-40% of adolescent athletes have EILO, an estimated 4-6 million nationwide. The most common treatment for EILO is Speech Therapy, with or without Physical Therapy. Where available, this requires significant time and financial commitment from patients and their families to attend therapy sessions and complete at-home exercises.
Case reports as early as 1985 have suggested aerosolized ipratropium bromide as an effective EILO treatment. One larger study could not confirm this observation. However, this study used an outcome measure with low reliability and validity, did not use a placebo control, and administered a low dose of ipratropium bromide too close to exercise.
The investigators propose a study that compares breathlessness and airway obstruction during intense exercise in 34 children and adolescents with EILO following inhalation of a higher dose of nebulized ipratropium bromide with placebo. It is hypothesized that breathlessness and airway obstruction will be lower following inhalation of ipratropium bromide compared with placebo.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: John M Robertson, MD
- Phone Number: 682-303-4200
- Email: john.robertson@cookchildrens.org
Study Contact Backup
- Name: Andreas Kreutzer, PhD
- Phone Number: 682-303-7576
- Email: andy.kreutzer@cookchildrens.org
Study Locations
-
-
Texas
-
Prosper, Texas, United States, 75078
- Cook Children's Pulmonology (Exercise Respiratory Center)
-
Contact:
- John M Robertson, MD
- Phone Number: 682-303-4200
- Email: john.robertson@cookchildrens.org
-
Contact:
- Andreas Kreutzer, PhD
- Email: andy.kreutzer@cookchildrens.org
-
Principal Investigator:
- John M Robertson, MD
-
Sub-Investigator:
- Andreas Kreutzer, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients must be diagnosed with EILO confirmed by Continuous Laryngoscopy During Exercise
- Patients must be able to complete exercise testing
- Patients must report dyspnea
- Patients must have given assent with parental consent, understand all study procedures, and comply with them for the entire length of the study.
Exclusion Criteria:
- Patients that do not have EILO.
- Patients who did not undergo diagnostic CPET with CLE.
- Patients with hypersensitivity to atropine or its derivatives due to structural similarity with ipratropium bromide.
- Patients with a history of atrial flutter and/or fibrillation
- Patients taking anticholinergic medications that cannot be paused for 24 hours.
- Unable to perform exercise tests
- Current drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
- Inability or unwillingness of patient or parent/legally authorized representative to give written informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ipratropium Bromide, then Placebo
Participants will receive Ipratropium Bromide in their first trial and Placebo in the second trial.
|
Nebulized Ipratropium Bromide (500µg/2.5mL);
one-time dose approximately 75 minutes before exercise, inhaled for 5-8 minutes
3 mL of nebulized 0.9% normal saline; one-time dose approximately 75 minutes before exercise, inhaled for 5-8 minutes
|
|
Experimental: Placebo, then Ipratropium Bromide
Participants will receive Placebo in their first trial and Ipratropium Bromide in the second trial.
|
Nebulized Ipratropium Bromide (500µg/2.5mL);
one-time dose approximately 75 minutes before exercise, inhaled for 5-8 minutes
3 mL of nebulized 0.9% normal saline; one-time dose approximately 75 minutes before exercise, inhaled for 5-8 minutes
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual Analogue Scale for Dyspnea (VAS-Dyspnea)
Time Frame: Day1 and Day 2
|
Shortness of breath assessed by a 0-100 Visual Analogue Scale for Dyspnea, where higher scores reflect greater breathlessness
|
Day1 and Day 2
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CLE grade scoring
Time Frame: Day 1 and Day 2
|
Patient videos will be assessed for laryngeal obstruction by two expert reviewers.
Blinded reviewers will grade the severity of glottic and supraglottic obstruction on a scale from 0 (no obstruction) to 3 (severe obstruction).
|
Day 1 and Day 2
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Organic Chemicals
- Heterocyclic Compounds
- Pharmaceutical Preparations
- Alkaloids
- Crystalloid Solutions
- Isotonic Solutions
- Solutions
- Aza Compounds
- Heterocyclic Compounds, Bridged-Ring
- Atropine Derivatives
- Tropanes
- Azabicyclo Compounds
- Belladonna Alkaloids
- Solanaceous Alkaloids
- Bridged Bicyclo Compounds, Heterocyclic
- Ipratropium
- Saline Solution
Other Study ID Numbers
Other Study ID Numbers
- 2026-031
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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