- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04140097
Predictors of Acute Exacerbation in Patients With COPD - an Observational Study (PACE)
Predictors of Acute Exacerbation in Patients With COPD - an Observational Study (PACE Trial)
Study Overview
Status
Intervention / Treatment
Detailed Description
In total, 355 COPD patients will be included prospectively to this study during a 3-week inpatient pulmonary rehabilitation programme at the Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, (Germany). All patients will be closely monitored from admission to the study. Measures of lung function, blood samples, breath sampling, exercise tests, physical activity monitoring, cardiac parameters, quality of life and a symptom diary will be recorded regularly. Prior knowledge from this programme suggest that about 15% of patients will develop an AECOPD during this observational phase. If a patient develops an AECOPD there will be a comprehensive diagnostic assessment to differentiate between cardiac, pulmonary or cardio-pulmonary reasons for the AECOPD and to identify the type of exacerbation. The clinical diagnosis and management of an AECOPD will be determined by a pulmonologist according to criteria of international guidelines within the first 24h after the onset of clinical symptoms suggestive of an exacerbation. Collected clinical data from the days prior to AECOPD will be analyzed comprehensively to identify parameters with high prediction power for AECOPD. Furthermore, patients will perform follow-up measures at 6, 12 and 24 months following the initial observational phase (PR phase).
A wide range of predictor screening methods will be applied to identify significant predictors including cross tabulation tables, correlations, generalized linear models, mixed models, generalized estimation equation models and various predictor screening methods based on variable selection algorithms.
Study objectives Primary endpoint: To prospectively identify potential early, respiratory and/ or cardiac clinical predictors, laboratory parameters, breath print analyses and/ or changes in lung function and physical activity prior to an AECOPD in COPD patients.
Secondary endpoint(s):
- To identify potential mechanisms explaining the nature and composition of an acute exacerbation in COPD patients
- To identify and differentiate patterns of acute COPD exacerbation versus cardiac failure in COPD patients
- To investigate the potential role of an electronic-nose to capture exhaled breath metabolomic profiles for the early detection of an acute exacerbation in COPD patients ("COPD pre exacerbation breath print")
- To identify parameters influencing mortality and other adverse events in the total study cohort at 6, 12 and 24 months follow up
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Rainer Gloeckl, PhD
- Phone Number: +49-8652-931630
- Email: rgloeckl@schoen-klinik.de
Study Locations
-
-
-
Schoenau Am Koenigssee, Germany, 83471
- Recruiting
- Schoen Klinik Berchtesgadener Land
-
Contact:
- Rainer Gloeckl, PhD
- Phone Number: 08652-931630
- Email: rgloeckl@schoen-klinik.de
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- confirmed diagnosis of Chronic Obstructive Pulmonary Disease according to Global Association for Obstructive Lung Disease stage II to IV
- the ability to follow the rehabilitation protocol
- provided written informed consent
Exclusion Criteria:
- current primary diagnosis of asthma
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
COPD patients with acute exacerbation
|
Patients will be recruited during an inpatient pulmonary rehabilitation program.
This setting offers a unique opportunity to study the phenomenon of an acute exacerbation of the Chronic Obstructive Pulmonary Disease prior to the first visible clinical sign and further on to have a follow up of the underlying mechanisms.
All COPD patients that are referred to the reference center for a rehabilitation program will be included after providing written informed consent.
Prospectively, a wide range of measurements will be collected.
If a patient develops an acute exacerbation there will be a comprehensive diagnostic assessment to differentiate between pulmonary, cardiac or cardio-pulmonary reasons for the exacerbation.
The clinical diagnosis of an AECOPD will be made by a pulmonologist according to criteria of international guidelines within the first 24h of clinical symptoms suggestive of an exacerbation.
|
COPD patients without acute exacerbation
|
Patients will be recruited during an inpatient pulmonary rehabilitation program.
This setting offers a unique opportunity to study the phenomenon of an acute exacerbation of the Chronic Obstructive Pulmonary Disease prior to the first visible clinical sign and further on to have a follow up of the underlying mechanisms.
All COPD patients that are referred to the reference center for a rehabilitation program will be included after providing written informed consent.
Prospectively, a wide range of measurements will be collected.
If a patient develops an acute exacerbation there will be a comprehensive diagnostic assessment to differentiate between pulmonary, cardiac or cardio-pulmonary reasons for the exacerbation.
The clinical diagnosis of an AECOPD will be made by a pulmonologist according to criteria of international guidelines within the first 24h of clinical symptoms suggestive of an exacerbation.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline laboratory parameters at day 21
Time Frame: baseline and day 21
|
following Parameters will be collected: c-reactive protein, cardiac Troponin I, hemoglobin A1c, Interleukin-1 beta, Interleukin-2, Interleukin-6, Interleukin 8, N-terminal probrain natriuretic peptide, Tumor necrosis factor alpha
|
baseline and day 21
|
Change from day 1 of an acute exacerbation in laboratory parameters at day 5
Time Frame: day 1 and 5 in case of an acute exacerbation
|
following Parameters will be collected: c-reactive protein, cardiac Troponin I, hemoglobin A1c, Interleukin-1 beta, Interleukin-2, Interleukin-6, Interleukin 8, N-terminal probrain natriuretic peptide, Tumor necrosis factor alpha
|
day 1 and 5 in case of an acute exacerbation
|
Change from baseline lung function at day 21
Time Frame: baseline and day 21
|
following Parameters will be collected: forced expiratory volume in 1 sec, forced vital capacity, total lung capacity, residual volume
|
baseline and day 21
|
Change from day 1 of an acute exacerbation in lung function at day 5
Time Frame: day 1 and 5 in case of an acute exacerbation
|
following Parameters will be collected: forced expiratory volume in 1 sec, forced vital capacity, total lung capacity, residual volume
|
day 1 and 5 in case of an acute exacerbation
|
Change from baseline Cardiac Doppler echocardiography at day 21
Time Frame: baseline and day 21
|
Left and right heart echocardiography will be performed
|
baseline and day 21
|
Change from day 1 of an acute exacerbation in Cardiac Doppler echocardiography at day 5
Time Frame: day 1 and 5 in case of an acute exacerbation
|
Left and right heart echocardiography will be performed
|
day 1 and 5 in case of an acute exacerbation
|
Change from baseline breath volatile organic compounds Analysis to day 4, 8, 11, 15 and 18
Time Frame: day 1, 4, 8, 11, 15, 18
|
breath samples will be analyzed by ion-mobility spectrometry and gaschromatography/mass spectrometry
|
day 1, 4, 8, 11, 15, 18
|
Change in baseline exercise Performance at day 21
Time Frame: day 1 and 21
|
following tests will be performed: 6-Minute walk test, sit-to-stand-test, Peak quadriceps and Hand grip force,
|
day 1 and 21
|
Change from baseline Quality of life assessed by Short Form - 36 Questionnaire at days 21, day 180, day360, day 720
Time Frame: baseline, day 21, day 180, day 360, day 720
|
the scale of the physical and mental Health component summary score ranges from 0 to 100 Points with higher scores indicating better Quality of lif
|
baseline, day 21, day 180, day 360, day 720
|
Change from baseline functional status assessed by Modified Medical Research Counsil score at days 21, day 180, day360, day 720
Time Frame: baseline, day 21, day 180, day 360, day 720
|
the score ranges from category 0 to 4 with higher scores indicating higher impairment in function status
|
baseline, day 21, day 180, day 360, day 720
|
Change from baseline anxiety status assessed by Chronic Obstructive Pulmonary Disease Anxiety Questionnaire at days 21, day 180, day360, day 720
Time Frame: baseline, day 21, day 180, day 360, day 720
|
the total score ranges from 0 to 112 Points with higher scores indicating worse anxiety status
|
baseline, day 21, day 180, day 360, day 720
|
Change from baseline Depression status assessed by Patient Health Questionnaire 9 at days 21, day 180, day360, day 720
Time Frame: baseline, day 21, day 180, day 360, day 720
|
the total score ranges from 0 to 27 Points with higher scores indicating worse Depression symptoms
|
baseline, day 21, day 180, day 360, day 720
|
Change from baseline disease specific Quality of life assessed by Chronic Obstructive Pulmonary Disease Assessment Test at days 21, day 180, day360, day 720
Time Frame: baseline, (day 1 and 5 in case of an acute exacerbation), day 21, day 180, day 360, day 720
|
total score ranges from 0 to 40 points with higher scores indicating worse quality of life
|
baseline, (day 1 and 5 in case of an acute exacerbation), day 21, day 180, day 360, day 720
|
Self-reported patient diary
Time Frame: once daily from day 1 to day 21
|
The EXAcerbations of Chronic pulmonary disease Tool will be used
|
once daily from day 1 to day 21
|
physical activity monitoring
Time Frame: continuous monitoring from day 1 to day 21
|
Using the Actigraph device following Parameters will be collected: steps per day and physical activity levels
|
continuous monitoring from day 1 to day 21
|
Change in Survival Status from baseline at 6, 12 and 24 months
Time Frame: baseline, at 6, 12 and 24 months
|
Survival Status will be assessed by phone calls
|
baseline, at 6, 12 and 24 months
|
cough events
Time Frame: Recording from day 1 to day 21 at night only
|
Number of nocturnal cough events recorded by NELA sound device (Carepath)
|
Recording from day 1 to day 21 at night only
|
Collaborators and Investigators
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PACE Trial
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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