- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04000958
PIFR-based Inhalation Therapy in Patients Recovering From AECOPD
Optimized Inhalation Therapy Based on Peak Inspiratory Flow Rates Measured Against the Simulated Resistance in Patients Recovering From Acute Exacerbation of Chronic Obstructive Pulmonary Disease: a Randomized Trial (PIFR-OIT Study)
This study is designed to determine whether the optimized inhalation therapy based on peak inspiratory flow rates (PIFR) measured against the simulated resistance can reduce the rate of treatment failure in patients recovering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Errors in inhaler use and quality of life are also to be evaluated.
The study will recruit 460 patients with AECOPD whose exacerbated symptoms are relieved by 5-7 days of standard therapy. The participants are divided into PIFR group and control group in a 1:1 ratio according to a random number table method. All the patients will be given inhaled corticosteroid(ICS)/long-acting β agonist(LABA) (budesonide/ formoterolSymbicort turbuhaler® 160/4.5 μg bid or Beclometasone/ Formoterol Foster® pressure metered dose inhaler(pMDI) 100/6 μg 2 puff bid). For symptomatic patients before acute exacerbation, Spiriva handihaler® 18μg qd or Spiriva respimat® 2.5μg qd will be prescribed in combination with ICS/LABA. For PIFR group, PIFR is measured by InCheck DIAL(Clement Clarke International Ltd, Harlow, UK and Alliance Tech Medical). If PIFR is less than 60L/min , the patient will be given pMDI with spacer. If PIFR value is over 60 L/min, the patient will be given dry powder inhaler(DPI).). The control group will be given DPI or pMDI with spacer according to the judgment of a respiratory physician. Both groups will be taught to use the device after the prescription, and then be reminded to use medication via a WeChat public account.
The primary endpoint of the study is the 30-day treatment failure including AECOPD recurrence resulting in an emergency visit, admission, or need for intensified medication). The secondary endpoints of the study are the error rate of inhalation device use, satisfaction with inhalation devices, symptoms and quality of life, 30-day mortality, chronic obstructive pulmonary diseases(COPD)-related treatment costs and PIFR.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Shanghai, China, 200032
- Recruiting
- 180 Fenglin Road
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) whose acute respiratory symptoms have been controlled after 5-7 day-standard AECOPD treatment including atomized or inhaled brochodilator plus oral or intravenous glucocorticoid (prednisone equivalent dose 40-50mg) or Pulmicort 2mg atomization Bid plus broad-spectrum antibiotics.
- Patients with moderate and above chronic obstructive pulmonary disease diagnosed by spirometry, ie, forced expiratory volume in one second(FEV1)/forced vital capacity(FVC) <70% post-bronchodilator and FEV1% predicted value <80%.
- Patients have signed an informed consent form.
Exclusion Criteria:
- Patients who is already using home nebulization therapy because of the severity of the illness.
- Patients with bronchial asthma, pulmonary interstitial fibrosis, bronchiectasis, pulmonary embolism and other lung diseases; or hypertension, heart disease, chronic liver and kidney disease, diabetes, chronic gastrointestinal diseases, malignant tumors, critically ill patients.
- Patient's mental state cannot match the observation or suffer from cognitive impairment.
- Patient's peak inspiratory flow rates (PIFR) is less than 20L/min.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: control group
|
The choice of inhalers depends on physician's evaluation.
The medication is the same as experimental group.
|
Experimental: PIFR group
|
Peak inspiratory flow rates(PIFR) will be measured using the InCheck DIAL(Clement Clarke International Ltd, Harlow, UK and Alliance Tech Medical).
The InCheck DIAL is accurate to +/- 10% or 10 L/min, whichever is greater, and can measure flows in the range of 15 to 120 L/min.
Dry powder inhaler(DPI) is to be prescribed if PIFRr is over 60L/min, otherwise pressure metered dose inhaler(pMDI) with spacer is given.
All the patients will be given inhaled corticosteroid(ICS)/long-acting β agonist(LABA).
For symptomatic patients, long-acting anticholinergic agents(LAMA) will also be used.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
30-day treatment failure rate
Time Frame: 30 days
|
Treatment failure means AECOPD recurrence resulting in an emergency visit, admission, or need for intensfied medication.
|
30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
30-day mortality
Time Frame: 30 days
|
30 days
|
|
90-day mortality
Time Frame: 90 days
|
90 days
|
|
the error rate of inhalation device use
Time Frame: 30 days/ 90 days
|
30 days/ 90 days
|
|
satisfaction with inhalation devices
Time Frame: 30 days/ 90 days
|
Patients' satisfaction with inhalation devices will be assessed by the following items. If the patient meets any of the following, the result will be unsatisfactory:
|
30 days/ 90 days
|
score of St.George's Respiratory Questionnaire(SGRQ)
Time Frame: 30 days/ 90 days
|
St.George's Respiratory Questionnaire(SGRQ) is used to assess patient's quality of life. The SGRQ scale range is from 0 to 100. The higher the score is, the more severe the impact of COPD on patient' life is. |
30 days/ 90 days
|
COPD-related treatment costs
Time Frame: 30 days/ 90 days
|
30 days/ 90 days
|
|
Peak Inspiratory Flow Rates(PIFR)
Time Frame: 30 days/ 90 days
|
30 days/ 90 days
|
|
score of modified British medical research council(mMRC)
Time Frame: 30 days/ 90 days
|
Modified British medical research council(mMRC) is used to assess patient's symptoms. The mMRC scale range is from 0 to 4. The higher the score is, the more severe the patient's dyspnea is. |
30 days/ 90 days
|
score of COPD assessment test(CAT)
Time Frame: 30 days/ 90 days
|
COPD assessment test(CAT) is used to assess patient's symptoms.
The CAT scale range is from 0 to 40.
A score of 0-10 indicates the patient is slightly affected by COPD.
A score of 11-20 indicates the patient is moderately affected by COPD.
A score of 21-30 indicates the patient is seriously affected by COPD.
A score of 31-40 indicates the patient is extremely affected by COPD.
|
30 days/ 90 days
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- B2019-142
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
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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