- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03474471
A Trial on the Effects of Bronchoscopic Lung Volume Reduction in Severe Emphysema. (SOLVE)
A Prospective Randomized Controlled Trial on the Systemic Effects of Bronchoscopic Lung Volume Reduction in Patients With Severe Emphysema.
Rationale: The published clinical trials investigating the bronchoscopic lung volume reduction, showing important patient-related improvements in efficacy, led to the acknowledgement of the treatment in the GOLD-COPD2017 guidelines. Interaction with pulmonary rehabilitation, impact on patient-reported outcomes, physical activity, and extrapulmonary consequences are all topics to gain more insight in. This importantly, to further develop and optimize this innovative and personalized therapy.
Objective: To study in detail the impact and optimal timing of pulmonary rehabilitation (PR) on exercise physiology and patient-reported outcomes and the impact of the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) on cardiopulmonary function, metabolism and changes in body composition.
Study design: This study is a randomized controlled trial with 3 study-arms. Group 1 will first follow a PR program and afterwards undergo the EBV treatment. Group 2 will first undergo the EBV treatment and approximately 8 weeks later will follow a PR program. Group 3 will only undergo the EBV treatment (and can choose to follow a PR program after completing the 6 month FU visit).
Study population: The study population exist of patients with severe emphysema who undergo a bronchoscopic lung volume reduction treatment using one-way valves.
Intervention: Most patients will undergo a bronchoscopic lung volume reduction treatment using endobronchial valves and a pulmonary rehabilitation program. One group of patient will under a bronchoscopic lung volume reduction treatment using endobronchial valves and can choose whether they also want to follow a pulmonary rehabilitation program afterwards.
Main study parameters: The main study parameter is the difference in change in endurance time measured by an endurance cycle test between the EBV treatment group and the bronchoscopic lung volume reduction + rehabilitation group (EBV+PR).
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Rationale: The published clinical trials investigating the bronchoscopic lung volume reduction, showing important patient-related improvements in efficacy, led to the acknowledgement of the treatment in the GOLD-COPD2017 guidelines. Interaction with pulmonary rehabilitation, impact on patient-reported outcomes, physical activity, and extrapulmonary consequences are all topics to gain more insight in. This importantly, to further develop and optimize this innovative and personalized therapy.
Objective: To study in detail the impact and optimal timing of pulmonary rehabilitation (PR) on exercise physiology and patient-reported outcomes and the impact of the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) on cardiopulmonary function, metabolism and changes in body composition.
Study design: This study is a randomized controlled trial with 3 study-arms. Group 1 will first follow a PR program and afterwards undergo the EBV treatment. Group 2 will first undergo the EBV treatment and approximately 8 weeks later will follow a PR program. Group 3 will only undergo the EBV treatment (and can choose to follow a PR program after completing the 6 month FU visit).
Study population: The study population exist of patients with severe emphysema who undergo a bronchoscopic lung volume reduction treatment using one-way valves.
Intervention: Most patients will undergo a bronchoscopic lung volume reduction treatment using endobronchial valves and a pulmonary rehabilitation program. One group of patient will under a bronchoscopic lung volume reduction treatment using endobronchial valves and can choose whether they also want to follow a pulmonary rehabilitation program afterwards.
Main study parameters: The main study parameter is the difference in change in endurance time measured by an endurance cycle test between the EBV treatment group and the bronchoscopic lung volume reduction + rehabilitation group (EBV+PR).
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: This study has no major risks for the participating patients. The patients will be exposed to additional exercise capacity and physical activity measurements, 3 additional questionnaires, a CT scan of the quadriceps muscle, a DEXA scan and peripheral blood collection. Furthermore, a subgroup of patients will be exposed to a cardiac MRI or muscle and fat biopsies. Patient can directly benefit from the EBV treatment and the pulmonary rehabilitation program. Indirect benefit might be achieved, because, at a group level the investigators will learn more about this novel treatment for our severe emphysema patients and will be able to further optimize this treatment.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Dirk-Jan Slebos, MD PhD
- Phone Number: +31503616161
- Email: d.j.slebos@umcg.nl
Study Locations
-
-
-
Groningen, Netherlands
- University Medical Center Groningen
-
Horn, Netherlands
- Ciro
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- COPD.
- FEV1 ≤45%pred AND FEV1/FVC <70%.
- TLC >100%pred AND RV>175%pred.
- CAT ≥18.
- >50% emphysema destruction @-910HU.
- >95% complete major fissure measured by quantitative CT analysis.
- Non-smoking >6 months.
- Signed informed consent.
Exclusion Criteria:
- PaCO2>8.0 kPa, or PaO2<6.0kPa.
- 6-minute walk test <160m.
- Significant chronic bronchitis, bronchiectasis, or other infectious lung disease.
- 3 of more hospitalizations due to pulmonary infection within last 12 months before baseline assessments
- Previous lobectomy, LVRS, or lung transplantation.
- LVEF<45% and or RVSP>50mmHg.
- Anticoagulant therapy which cannot be weaned off prior to procedure.
- Patient is significantly immunodeficient.
- Involved in other pulmonary drug studies within 30 days prior to this study.
- Pulmonary nodule which requires intervention
- Any disease or condition that interferes with completion of initial or follow-up assessments
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Group 1:PR-EBV treatment
Follow a Pulmonary rehabilitation program PRIOR to the EBV treatment
|
Following a PR program
Bronchoscopic lung volume reduction using endobronchial valves (EBV)
|
Experimental: Group 2: EBV treatment-PR
Follow a Pulmonary rehabilitation program AFTER the EBV treatment
|
Following a PR program
Bronchoscopic lung volume reduction using endobronchial valves (EBV)
|
Active Comparator: Group 3: EBV treatment
Only EBV treatment
|
Bronchoscopic lung volume reduction using endobronchial valves (EBV)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Endurance time
Time Frame: After 6 months
|
The difference in change in endurance time measured by an endurance cycle test between the EBV treatment group and the bronchoscopic lung volume reduction + rehabilitation group (EBV+PR).
|
After 6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pulmonary rehabilitation1
Time Frame: After 6 months
|
• the difference between the EBV treatment group and the EBV+PR group in change in:
|
After 6 months
|
Pulmonary rehabilitation2
Time Frame: After 6 months
|
• the difference between the EBV treatment group and the EBV+PR group in change in:
|
After 6 months
|
Pulmonary rehabilitation3
Time Frame: After 6 months
|
• the difference between the EBV treatment group and the EBV+PR group in change in:
|
After 6 months
|
Patient reported outcomes
Time Frame: After 6 months
|
• the change after EBV treatment in fatigue level measured by the CIS questionnaire.
|
After 6 months
|
Cardiopulmonary function
Time Frame: After 8 weeks
|
• the change after EBV treatment in RVEDVI as measured with cardiac MRI.
|
After 8 weeks
|
Metabolism and change in body composition
Time Frame: After 8 weeks
|
• the change after EBV treatment in fat-free mass index, fat mass, and fat distribution measured by a dexa scan.
|
After 8 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Dirk-Jan Slebos, MD PhD, UMCG
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SOLVE
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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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