- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07721922
Efficacy of Nebulized Long-Acting Bronchodilators (Formoterol and Revefenacin) vs. Short-Acting Bronchodilators (Albuterol and Ipratropium) in Patients Presenting to the Emergency Department With Acute Exacerbation of COPD (ECOPD)
Efficacy of Nebulized Long-Acting Bronchodilators (Formoterol and Revefenacin) vs. Short-Acting Bronchodilators (Albuterol and Ipratropium) in Patients Presenting to the Emergency Department With Acute Exacerbation of COPD (ECOPD): A Phase IV, Prospective, Randomized, Blinded, Parallel-group Trial
The primary aim is to determine whether nebulized Formoterol twice daily plus Revefenacin once daily is non-inferior to standard-of-care nebulized Albuterol and Ipratropium therapy four times daily in relieving dyspnea among patients with ECOPD presenting to the ED and requiring hospitalization, as measured by the Modified Borg Dyspnea Scale.
The hypothesize is that patients in the ED for ECOPD, improvement in symptoms, safety, and length of ED or hospital stay after treatment with nebulized Revefenacin and Formoterol will be non-inferior to the Albuterol and Ipratropium combination. The long-acting bronchodilator regimen will provide comparable symptom control with fewer total drug doses compared with standard treatment with short-acting bronchodilators, namely, nebulized Albuterol and Ipratropium. To the best of our knowledge, this will be the first prospective, randomized, double-blind investigation to compare a combination of long-acting nebulized LAMA/LABA bronchodilators with a standard-of-care combination of short-acting nebulized SAMA/SABA bronchodilators in patients with an ECOPD in the ED/hospital setting.
Přehled studie
Postavení
Podmínky
Typ studie
Zápis (Odhadovaný)
Fáze
- Fáze 4
Kontakty a umístění
Studijní místa
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Tennessee
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Knoxville, Tennessee, Spojené státy, 37920
- University of Tennessee Medical Center
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Kontakt:
- Jennifer Ferris, MSHS
- Telefonní číslo: 865-305-7975
- E-mail: jferris@utmck.edu
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Male or Female
- Any Race
- ≥ 40 years of age
- History of COPD based on EMR or confirmed verbally by the patient
- Presenting to the ED with a primary diagnosis of ECOPD or acute respiratory failure with a secondary diagnosis of COPD
- Able to understand and comply with study procedures
- Willingness to sign and date an Informed Consent Form
Exclusion Criteria:
- Patients unable or unwilling to sign an informed consent or cooperate with study procedures
- Patients who are hypersensitive to Formoterol or Revefenacin
- Patients who are intubated, have tracheotomy, are receiving mechanical ventilation by mask or artificial airway
- Patients who have previously participated in the study
Patients, in the opinion of the investigators, who are rapidly decompensating and are immediately in need, or will soon need, ventilator support based on:
i. Inability to maintain respiratory effort ii. Cyanosis iii. Hemodynamic instability iv. Deterioration in mental status
- Patients who, per the investigator, have unstable cardiovascular disease (e.g., uncontrolled hypertension, unstable angina, recent MI (within 12 weeks), ventricular arrhythmia, or decompensated heart failure)
- Patients with a current diagnosis of lung cancer requiring treatment
- Pulmonary diseases other than COPD, or lobar pneumonia
- Patients with acute psychiatric illness deemed significant by the investigator
- Patients with a history of glaucoma deemed significant by the investigator
- History of urinary retention deemed significant by the investigator
- Women who are pregnant or breastfeeding
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Group 1: Revefenacin (YUPELRI) & Formoterol (Perforomist)
Participants will receive Revefenacin 175 µg once daily and Formoterol 20 µg twice daily via a jet nebulizer for up to 7 days or until hospital discharge (if discharge occurs before Day 7).
Participants will also receive placebo (sterile normal saline) to maintain blinding and mask the difference in dosing frequency compared with the comparator arm.
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Revefenacin 175 µg in 3 mL inhalation solution administered once daily in the morning via oral inhalation using a jet nebulizer.
Ostatní jména:
Formoterol fumarate 20 μg in 2 mL inhalation solution administered twice daily in the morning and evening via oral inhalation using a jet nebulizer.
Ostatní jména:
Twice daily (sterile normal saline 3 ml) to maintain blinding and mask the difference in dosing frequency compared with the comparator arm.
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Aktivní komparátor: Group2: Ipratropium Bromide (Atrovent) & Albuterol (Ventolin)
Albuterol and Ipratropium every 6 hours nebulized over the 7-day treatment period or until discharge if prior to day 7.
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Albuterol sulfate 2.5 mg in 3 mL inhalation solution administered 4 times daily via oral inhalation using a jet nebulizer.
Ostatní jména:
Ipratropium Bromide 500 μg in 2.5 mL inhalation solution administered 4 times daily via oral inhalation using a jet nebulizer.
Ostatní jména:
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Difference in Modified Borg Dyspnea Scale scores between groups
Časové okno: From enrollment through Day 7 (end of treatment)
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This is a scale asks the subject to rate the difficulty of their breathing.
It starts at number 0 where breathing is causing no difficulty at all and progresses through to number 10 where breathing difficulty is maximal.
This will be recorded prior to dosing twice a day between 7 and 9 am & pm.
Scores from Group 1 and Group 2 will be averaged and compared.
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From enrollment through Day 7 (end of treatment)
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Number of patients discharged home from the ED
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Number of patients admitted to a hospital floor or require ED observation for >24 hours (in-hospital patients)
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Length of hospital or ED stay
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Number of Participants with the Need to Switch Therapy
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Total number of bronchodilator doses per hospital or ED stay
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Total number of rescue doses used
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Number of Participants with Failure of Treatment (Need for Mechanical Ventilation or Death
Časové okno: From enrollment through Day 7 (end of treatment)
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Failure of treatment will be defined as any of the following: death, the need for a patient to receive mechanical ventilation, or the need for a patient to discontinue long-acting bronchodilators during the trial.
The need for rescue medications while maintaining the assigned treatment will not be considered a failure of treatment.
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From enrollment through Day 7 (end of treatment)
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Number of Participants Requiring Supplemental Oxygen
Časové okno: From enrollment through Day 7 (end of treatment)
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From enrollment through Day 7 (end of treatment)
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Differences in FEV1/FVC values between enrollment and discharge/end of study.
Časové okno: From enrollment through Day 7 (end of treatment)
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Bedside spirometry will be performed by respiratory therapists with the patient in a sitting position using a handheld portable spirometer.
The patient will be asked to make a tight seal around the mouthpiece with their lips and forcefully exhale after a deep inhalation.
The patient will be instructed to continue forceful and rapid exhalation until no more air is expelled from their lungs.
The best of 3 efforts will be used for analysis.
FEV1/FVC<0.7 will be used to diagnose airflow obstruction.
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From enrollment through Day 7 (end of treatment)
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Spolupracovníci a vyšetřovatelé
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Organické chemikálie
- Heterocyklické sloučeniny
- Alkaloidy
- Aminy
- Alkoholy
- Aza sloučeniny
- Amino alkoholy
- Ethanolaminy
- Fenylaminy
- Ethylaminy
- Heterocyklické sloučeniny, přemostěný prsten
- Deriváty atropinu
- Tropany
- Azabicyklové sloučeniny
- Alkaloidy Belladonna
- Solanaceous alkaloidy
- Přemostěné sloučeniny Bicyclo, heterocyklika
- Formoterol fumarát
- Albuterol
- Ipratropium
- revefenacin
Další identifikační čísla studie
- 5482
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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